CMS Formulary

Displaying 227521-227530 of 1611142 results.
ID: 227521
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 477372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227522
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 227523
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 227524
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227525
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227526
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227527
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 227528
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 227529
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 227530
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30