CMS Formulary

Displaying 220001-220010 of 1611142 results.
ID: 220001
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220002
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220003
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220004
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220005
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220006
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220007
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220008
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 220009
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220010
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30