CMS Formulary

Displaying 220491-220500 of 1611142 results.
ID: 220491
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220492
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220493
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220494
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220495
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220496
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 220497
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220498
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220499
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220500
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0