CMS Formulary

Displaying 224651-224660 of 1611142 results.
ID: 224651
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 224652
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224653
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224654
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224655
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 404587
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224656
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 680
Qty Limit Days: 28
ID: 224657
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 639888
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224658
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744003
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224659
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224660
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744011
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30