CMS Formulary

Displaying 210861-210870 of 1611142 results.
ID: 210861
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210862
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210863
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210864
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 210865
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210866
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 210867
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 210868
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 210869
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210870
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373469
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30