CMS Formulary

Displaying 100221-100230 of 1611142 results.
ID: 100221
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 100222
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 100223
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 100224
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100225
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100226
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 100227
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 100228
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 100229
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100230
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0