CMS Formulary

Displaying 220111-220120 of 1611142 results.
ID: 220111
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 220112
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 220113
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 220114
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220115
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220116
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220117
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220118
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220119
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220120
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30