CMS Formulary

Displaying 226641-226650 of 1611142 results.
ID: 226641
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226642
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226643
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226644
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226645
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226646
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226647
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 226648
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 90
ID: 226649
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 226650
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30