CMS Formulary

Displaying 210691-210700 of 1611142 results.
ID: 210691
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210692
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210693
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210694
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210695
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210696
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210697
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210698
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 903847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210699
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210700
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0