CMS Formulary

Displaying 229331-229340 of 1611142 results.
ID: 229331
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229332
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229333
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229334
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229335
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 977860
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229336
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 229337
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 229338
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 229339
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229340
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0