CMS Formulary

Displaying 224891-224900 of 1611142 results.
ID: 224891
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224892
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 224893
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224894
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224895
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224896
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224897
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224898
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 280
Qty Limit Days: 28
ID: 224899
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 224900
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28