CMS Formulary

Displaying 223521-223530 of 1611142 results.
ID: 223521
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223522
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223523
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223524
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223525
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223526
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 223527
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 223528
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223529
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 223530
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30