CMS Formulary

Displaying 210571-210580 of 1611142 results.
ID: 210571
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210572
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210573
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210574
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210575
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210576
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210577
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 210578
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210579
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210580
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30