CMS Formulary

Displaying 225861-225870 of 1611142 results.
ID: 225861
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 746804
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 225862
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 746815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 225863
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 746813
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 225864
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 790284
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 225865
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2196792
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 225866
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2196592
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 225867
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1536144
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 225868
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1536148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 225869
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225870
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0