CMS Formulary

Displaying 230331-230340 of 1611142 results.
ID: 230331
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 230332
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 230333
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 230334
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 230335
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 230336
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 230337
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 230338
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 230339
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1602120
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 230340
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30