CMS Formulary

Displaying 229691-229700 of 1611142 results.
ID: 229691
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229692
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229693
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229694
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229695
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229696
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229697
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229698
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5550
Qty Limit Days: 30
ID: 229699
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229700
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0