CMS Formulary

Displaying 99261-99270 of 1611142 results.
ID: 99261
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99262
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 99263
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99264
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99265
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99266
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99267
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99268
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99269
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 99270
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0