CMS Formulary

Displaying 212211-212220 of 1611142 results.
ID: 212211
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212212
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212213
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212214
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212215
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212216
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 212217
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212218
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 212219
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212220
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0