CMS Formulary

Displaying 221641-221650 of 1611142 results.
ID: 221641
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221642
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221643
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221644
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221645
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221646
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221647
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221648
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221649
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221650
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0