CMS Formulary

Displaying 220541-220550 of 1611142 results.
ID: 220541
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220542
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220543
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220544
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220545
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 220546
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 220547
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 220548
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220549
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 220550
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30