CMS Formulary

Displaying 225141-225150 of 1611142 results.
ID: 225141
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225142
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225143
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225144
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225145
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225146
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225147
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225148
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 225149
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225150
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0