CMS Formulary

Displaying 228331-228340 of 1611142 results.
ID: 228331
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 228332
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228333
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228334
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228335
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228336
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228337
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228338
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228339
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228340
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0