CMS Formulary

Displaying 224971-224980 of 1611142 results.
ID: 224971
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224972
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224973
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224974
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224975
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 224976
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224977
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224978
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224979
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224980
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0