CMS Formulary

Displaying 210081-210090 of 1611142 results.
ID: 210081
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210082
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210083
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210084
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210085
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210086
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210087
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 210088
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210089
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 210090
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30