CMS Formulary

Displaying 221851-221860 of 1611142 results.
ID: 221851
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 221852
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 221853
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221854
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 221855
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 221856
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 221857
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1996246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221858
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 846192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221859
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 759697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221860
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 759481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0