CMS Formulary

Displaying 212491-212500 of 1611142 results.
ID: 212491
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212492
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 212493
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 212494
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 904495
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 212495
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212496
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212497
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212498
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212499
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212500
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0