CMS Formulary

Displaying 99351-99360 of 1611142 results.
ID: 99351
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 99352
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 99353
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99354
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99355
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 99356
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99357
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 99358
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 99359
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99360
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30