CMS Formulary

Displaying 214851-214860 of 1611142 results.
ID: 214851
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214852
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214853
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214854
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214855
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214856
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214857
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214858
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214859
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214860
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0