CMS Formulary

Displaying 210961-210970 of 1611142 results.
ID: 210961
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210962
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210963
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210964
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861505
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 118
Qty Limit Days: 28
ID: 210965
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 210966
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 896110
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 210967
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210968
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1246096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 210969
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210970
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30