CMS Formulary

Displaying 224061-224070 of 1611142 results.
ID: 224061
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 224062
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 224063
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 224064
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545166
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224065
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545163
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224066
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545159
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224067
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545156
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224068
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 224069
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 224070
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28