CMS Formulary

Displaying 225291-225300 of 1611142 results.
ID: 225291
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225292
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 225293
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225294
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 313453
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225295
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225296
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225297
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225298
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 830877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225299
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 830879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225300
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 830882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0