CMS Formulary

Displaying 99651-99660 of 1611142 results.
ID: 99651
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99652
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99653
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99654
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99655
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99656
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99657
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 99658
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99659
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 99660
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0