CMS Formulary

Displaying 222241-222250 of 1611142 results.
ID: 222241
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 865098
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222242
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 752388
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222243
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 731281
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222244
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1652646
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222245
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 222246
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222247
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222248
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 222249
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2380236
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222250
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2380260
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0