CMS Formulary

Displaying 221421-221430 of 1611142 results.
ID: 221421
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221422
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221423
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221424
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221425
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221426
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221427
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221428
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221429
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221430
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0