CMS Formulary

Displaying 119221-119230 of 1611142 results.
ID: 119221
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 119222
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119223
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119224
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2286261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119225
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119226
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119227
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119228
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119229
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 119230
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84