CMS Formulary

Displaying 210621-210630 of 1611142 results.
ID: 210621
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1608274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210622
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210623
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210624
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797883
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210625
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210626
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210627
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 141859
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 210628
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 126
Qty Limit Days: 28
ID: 210629
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210630
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0