CMS Formulary

Displaying 99831-99840 of 1611142 results.
ID: 99831
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 99832
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99833
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99834
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99835
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99836
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99837
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99838
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99839
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 99840
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0