CMS Formulary

Displaying 211501-211510 of 1611142 results.
ID: 211501
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211502
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211503
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211504
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211505
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 30
ID: 211506
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211507
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211508
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211509
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211510
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 404587
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0