CMS Formulary

Displaying 222771-222780 of 1611142 results.
ID: 222771
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 222772
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 222773
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 222774
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 222775
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 222776
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 222777
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 222778
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 222779
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 222780
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30