CMS Formulary

Displaying 205721-205730 of 1611142 results.
ID: 205721
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 205722
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205723
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205724
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205725
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205726
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205727
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 205728
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205729
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205730
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0