CMS Formulary

Displaying 223261-223270 of 1611142 results.
ID: 223261
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223262
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223263
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 223264
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 223265
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223266
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1602120
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 223267
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223268
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223269
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223270
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1602115
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30