CMS Formulary

Displaying 99201-99210 of 1611142 results.
ID: 99201
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99202
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99203
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99204
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99205
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99206
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99207
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 905341
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99208
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99209
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99210
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30