CMS Formulary

Displaying 221771-221780 of 1611142 results.
ID: 221771
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221772
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221773
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221774
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221775
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221776
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221777
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221778
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221779
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221780
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0