CMS Formulary

Displaying 99291-99300 of 1611142 results.
ID: 99291
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 99292
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 99293
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99294
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99295
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 99296
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99297
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 99298
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99299
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99300
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0