CMS Formulary

Displaying 99571-99580 of 1611142 results.
ID: 99571
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99572
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 99573
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 99574
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 99575
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 99576
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 99577
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 99578
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 99579
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 99580
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28