CMS Formulary

Displaying 99771-99780 of 1611142 results.
ID: 99771
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370763
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 118
Qty Limit Days: 30
ID: 99772
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99773
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99774
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99775
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806890
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99776
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2184126
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 99777
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99778
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 99779
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99780
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30