CMS Formulary

Displaying 221261-221270 of 1611142 results.
ID: 221261
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 221262
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 221263
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221264
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221265
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221266
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221267
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 205918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221268
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 205922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221269
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 205924
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221270
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0