CMS Formulary

Displaying 212031-212040 of 1611142 results.
ID: 212031
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212032
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212033
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212034
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212035
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 212036
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212037
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212038
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212039
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212040
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0