CMS Formulary

Displaying 214841-214850 of 1611142 results.
ID: 214841
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214842
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 214843
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 214844
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 214845
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 214846
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 214847
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 214848
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 214849
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1100075
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214850
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30