CMS Formulary

Displaying 230161-230170 of 1611142 results.
ID: 230161
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230162
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230163
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230164
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230165
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 230166
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230167
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 230168
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230169
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230170
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0