CMS Formulary

Displaying 223771-223780 of 1611142 results.
ID: 223771
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223772
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223773
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223774
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223775
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1541099
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 236
Qty Limit Days: 28
ID: 223776
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223777
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223778
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223779
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 223780
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0