CMS Formulary

Displaying 228161-228170 of 1611142 results.
ID: 228161
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228162
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 308739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228163
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228164
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228165
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228166
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 30
ID: 228167
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 228168
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228169
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 228170
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 260218
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30