CMS Formulary

Displaying 231811-231820 of 1611142 results.
ID: 231811
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231812
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231813
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231814
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231815
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231816
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 231817
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 231818
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 231819
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 231820
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0