CMS Formulary

Displaying 214421-214430 of 1611142 results.
ID: 214421
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 214422
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 214423
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214424
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214425
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 214426
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 214427
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214428
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 214429
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 214430
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30