CMS Formulary

Displaying 224401-224410 of 1611142 results.
ID: 224401
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224402
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224403
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224404
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224405
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224406
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224407
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224408
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224409
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224410
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999