CMS Formulary

Displaying 99011-99020 of 1611142 results.
ID: 99011
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99012
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99013
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99014
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99015
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 99016
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 99017
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99018
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99019
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99020
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0