CMS Formulary

Displaying 227621-227630 of 1611142 results.
ID: 227621
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227622
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227623
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227624
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 227625
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 227626
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 227627
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 227628
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 227629
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227630
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0