CMS Formulary

Displaying 210931-210940 of 1611142 results.
ID: 210931
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 210932
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 210933
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210934
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 210935
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210936
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 210937
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 210938
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 210939
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 210940
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28