CMS Formulary

Displaying 99811-99820 of 1611142 results.
ID: 99811
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99812
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99813
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99814
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99815
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99816
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99817
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 99818
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99819
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99820
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30