CMS Formulary

Displaying 223161-223170 of 1611142 results.
ID: 223161
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223162
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223163
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223164
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223165
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 404062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223166
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 643488
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223167
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 404065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223168
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223169
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223170
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0