CMS Formulary

Displaying 221861-221870 of 1611142 results.
ID: 221861
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486691
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221862
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111020
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221863
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653221
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221864
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221865
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221866
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221867
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221868
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221869
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 221870
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 10