CMS Formulary

Displaying 99781-99790 of 1611142 results.
ID: 99781
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99782
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870960
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 99783
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870968
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 99784
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 99785
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 99786
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99787
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 852920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99788
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99789
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99790
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0