CMS Formulary

Displaying 225781-225790 of 1611142 results.
ID: 225781
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 180
ID: 225782
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 225783
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 225784
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 180
ID: 225785
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225786
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2166143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 225787
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2196900
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225788
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 180
ID: 225789
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1940709
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 225790
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0