CMS Formulary

Displaying 230041-230050 of 1611142 results.
ID: 230041
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 404061
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230042
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 404064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230043
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 230044
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 230045
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 230046
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230047
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230048
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1855389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230049
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230050
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30