CMS Formulary

Displaying 226381-226390 of 1611142 results.
ID: 226381
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226382
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226383
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 226384
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226385
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 226386
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1000093
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 226387
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226388
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226389
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 209789
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226390
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 209788
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0