CMS Formulary

Displaying 229021-229030 of 1611142 results.
ID: 229021
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229022
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229023
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229024
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229025
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229026
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229027
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 229028
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 229029
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 229030
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0