CMS Formulary

Displaying 223541-223550 of 1611142 results.
ID: 223541
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223542
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223543
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223544
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223545
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223546
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223547
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223548
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223549
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 485023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223550
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30