CMS Formulary

Displaying 225881-225890 of 1611142 results.
ID: 225881
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 225882
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225883
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225884
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225885
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225886
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225887
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225888
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225889
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 225890
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0