CMS Formulary

Displaying 214291-214300 of 1611142 results.
ID: 214291
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1860493
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214292
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1860495
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214293
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1860497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214294
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1860499
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214295
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1860501
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214296
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214297
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214298
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214299
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1435115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 214300
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0