CMS Formulary

Displaying 214141-214150 of 1611142 results.
ID: 214141
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214142
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300272
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 214143
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1541099
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 236
Qty Limit Days: 28
ID: 214144
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2180345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 214145
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214146
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214147
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214148
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214149
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214150
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0