CMS Formulary

Displaying 225711-225720 of 1611142 results.
ID: 225711
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 225712
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 225713
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 225714
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225715
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225716
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 225717
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225718
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225719
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225720
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28