CMS Formulary

Displaying 220651-220660 of 1611142 results.
ID: 220651
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 248642
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220652
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 220653
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 220654
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 220655
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220656
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 220657
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220658
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 220659
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220660
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0