CMS Formulary

Displaying 231831-231840 of 1611142 results.
ID: 231831
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 231832
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231833
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231834
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231835
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 308739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231836
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231837
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231838
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231839
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 30
ID: 231840
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30