CMS Formulary

Displaying 210561-210570 of 1611142 results.
ID: 210561
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210562
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210563
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210564
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210565
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210566
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210567
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210568
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210569
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210570
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0