CMS Formulary

Displaying 212411-212420 of 1611142 results.
ID: 212411
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212412
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212413
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212414
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212415
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212416
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212417
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1491634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212418
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 212419
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 212420
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0