CMS Formulary

Displaying 226891-226900 of 1611142 results.
ID: 226891
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226892
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226893
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226894
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226895
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226896
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226897
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226898
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226899
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226900
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30