CMS Formulary

Displaying 228851-228860 of 1611142 results.
ID: 228851
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228852
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 228853
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198116
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228854
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228855
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228856
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228857
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228858
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228859
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228860
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0