CMS Formulary

Displaying 221461-221470 of 1611142 results.
ID: 221461
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 221462
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221463
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 221464
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 221465
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221466
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 221467
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 221468
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 221469
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 221470
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30