CMS Formulary

Displaying 210281-210290 of 1611142 results.
ID: 210281
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210282
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210283
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 210284
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 210285
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 210286
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 210287
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 210288
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 210289
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 210290
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30