CMS Formulary

Displaying 230781-230790 of 1611142 results.
ID: 230781
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230782
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230783
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230784
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 230785
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 230786
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230787
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230788
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230789
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230790
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0