CMS Formulary

Displaying 224711-224720 of 1611142 results.
ID: 224711
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224712
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224713
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224714
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224715
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224716
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224717
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224718
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224719
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224720
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0