CMS Formulary

Displaying 221631-221640 of 1611142 results.
ID: 221631
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221632
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221633
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221634
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 221635
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 221636
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 221637
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600774
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221638
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221639
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600915
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221640
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0