CMS Formulary

Displaying 226971-226980 of 1611142 results.
ID: 226971
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 226972
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 226973
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226974
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226975
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226976
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226977
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226978
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226979
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226980
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0