CMS Formulary

Displaying 221-230 of 1611142 results.
ID: 221
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 222
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 223
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 224
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 225
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 226
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 227
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 228
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 229
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0