CMS Formulary

Displaying 209231-209240 of 1611142 results.
ID: 209231
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209232
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209233
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 212957
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209234
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209235
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 209236
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209237
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209238
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 209239
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209240
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0