CMS Formulary

Displaying 228141-228150 of 1611142 results.
ID: 228141
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228142
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228143
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 228144
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 228145
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 228146
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 228147
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228148
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228149
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228150
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30