CMS Formulary

Displaying 220271-220280 of 1611142 results.
ID: 220271
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220272
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220273
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220274
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220275
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220276
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220277
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 220278
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 220279
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 220280
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 22
Qty Limit Days: 28