CMS Formulary

Displaying 221741-221750 of 1611142 results.
ID: 221741
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221742
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221743
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221744
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221745
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221746
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221747
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221748
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221749
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221750
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30