CMS Formulary

Displaying 214871-214880 of 1611142 results.
ID: 214871
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214872
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214873
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214874
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 214875
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 214876
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 214877
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 214878
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 214879
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 214880
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30