CMS Formulary

Displaying 211871-211880 of 1611142 results.
ID: 211871
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211872
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211873
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1922783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211874
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211875
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211876
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211877
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211878
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211879
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211880
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0