CMS Formulary

Displaying 220871-220880 of 1611142 results.
ID: 220871
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220872
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220873
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 220874
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220875
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220876
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220877
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220878
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 220879
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 220880
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30