CMS Formulary

Displaying 225761-225770 of 1611142 results.
ID: 225761
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225762
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 225763
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 225764
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225765
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225766
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1994395
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225767
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1994389
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225768
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1994392
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 225769
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 855871
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225770
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0