CMS Formulary

Displaying 221111-221120 of 1611142 results.
ID: 221111
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221112
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221113
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221114
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221115
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221116
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221117
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 221118
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221119
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221120
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0