CMS Formulary

Displaying 226091-226100 of 1611142 results.
ID: 226091
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 847348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226092
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 847245
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226093
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 226094
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 226095
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 226096
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226097
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226098
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226099
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226100
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0