CMS Formulary

Displaying 228971-228980 of 1611142 results.
ID: 228971
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228972
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 228973
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 228974
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228975
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228976
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228977
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228978
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228979
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 485423
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228980
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 485421
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0