CMS Formulary

Displaying 212461-212470 of 1611142 results.
ID: 212461
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212462
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212463
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212464
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212465
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 607579
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212466
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 212467
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 212468
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 212469
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 212470
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0