CMS Formulary

Displaying 214111-214120 of 1611142 results.
ID: 214111
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214112
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214113
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214114
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214115
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214116
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214117
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214118
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214119
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214120
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28