CMS Formulary

Displaying 229741-229750 of 1611142 results.
ID: 229741
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2107522
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 229742
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 229743
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 229744
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 229745
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 229746
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 229747
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 229748
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 229749
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 229750
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 616238
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30