CMS Formulary

Displaying 229401-229410 of 1611142 results.
ID: 229401
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229402
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229403
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229404
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229405
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 229406
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 229407
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 229408
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 229409
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 229410
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30