CMS Formulary

Displaying 210661-210670 of 1611142 results.
ID: 210661
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210662
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 210663
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 210664
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210665
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 210666
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210667
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210668
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 236
Qty Limit Days: 28
ID: 210669
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210670
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0