CMS Formulary

Displaying 210851-210860 of 1611142 results.
ID: 210851
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210852
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 210853
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210854
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210855
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210856
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210857
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 212787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210858
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 210859
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210860
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0