CMS Formulary

Displaying 223391-223400 of 1611142 results.
ID: 223391
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223392
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223393
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223394
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223395
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223396
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223397
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223398
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223399
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 223400
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30