CMS Formulary

Displaying 225341-225350 of 1611142 results.
ID: 225341
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1944656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225342
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 197843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225343
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 197844
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225344
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 197845
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225345
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 365
ID: 225346
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 225347
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 225348
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 225349
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225350
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 310155
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0