CMS Formulary

Displaying 225821-225830 of 1611142 results.
ID: 225821
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 225822
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 225823
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 225824
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 225825
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 672152
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 225826
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 225827
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 225828
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225829
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225830
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 825429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0