CMS Formulary

Displaying 220181-220190 of 1611142 results.
ID: 220181
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220182
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30
ID: 220183
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220184
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220185
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220186
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 220187
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 220188
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 220189
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 220190
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0