CMS Formulary

Displaying 220581-220590 of 1611142 results.
ID: 220581
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220582
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220583
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220584
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 220585
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220586
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220587
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220588
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220589
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220590
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0