CMS Formulary

Displaying 98801-98810 of 1611142 results.
ID: 98801
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98802
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98803
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98804
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98805
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98806
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98807
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809730
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98808
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809738
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98809
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98810
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30