CMS Formulary

Displaying 225251-225260 of 1611142 results.
ID: 225251
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 225252
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225253
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225254
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225255
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225256
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225257
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225258
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225259
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225260
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30