CMS Formulary

Displaying 227361-227370 of 1611142 results.
ID: 227361
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 227362
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 227363
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227364
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 227365
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227366
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227367
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 236
Qty Limit Days: 28
ID: 227368
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227369
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227370
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0