CMS Formulary

Displaying 212081-212090 of 1611142 results.
ID: 212081
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 212082
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212083
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212084
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212085
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212086
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212087
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212088
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212089
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 359500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212090
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0