CMS Formulary

Displaying 230031-230040 of 1611142 results.
ID: 230031
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230032
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230033
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230034
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 208327
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230035
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 230036
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230037
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230038
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230039
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230040
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 404058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0