CMS Formulary

Displaying 99001-99010 of 1611142 results.
ID: 99001
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99002
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99003
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99004
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99005
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99006
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365847
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99007
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365850
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99008
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928954
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 99009
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99010
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0