CMS Formulary

Displaying 214921-214930 of 1611142 results.
ID: 214921
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214922
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214923
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214924
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 214925
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 214926
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 214927
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 214928
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 214929
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 214930
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0