CMS Formulary

Displaying 220531-220540 of 1611142 results.
ID: 220531
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220532
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220533
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220534
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220535
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220536
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220537
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220538
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220539
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220540
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30