CMS Formulary

Displaying 229141-229150 of 1611142 results.
ID: 229141
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 229142
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 229143
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 229144
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2265689
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 229145
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 30
ID: 229146
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 229147
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 229148
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229149
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 1247381
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229150
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0