CMS Formulary

Displaying 221371-221380 of 1611142 results.
ID: 221371
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221372
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221373
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221374
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221375
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221376
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221377
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221378
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221379
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221380
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0