CMS Formulary

Displaying 219741-219750 of 1611142 results.
ID: 219741
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219742
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219743
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219744
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219745
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219746
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219747
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219748
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219749
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219750
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0