CMS Formulary

Displaying 222551-222560 of 1611142 results.
ID: 222551
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222552
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222553
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222554
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222555
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 222556
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 404630
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222557
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 222558
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 222559
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 222560
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0