CMS Formulary

Displaying 225731-225740 of 1611142 results.
ID: 225731
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225732
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 225733
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225734
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225735
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225736
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 225737
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225738
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225739
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 702296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225740
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30