CMS Formulary

Displaying 212611-212620 of 1611142 results.
ID: 212611
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212612
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212613
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212614
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1304979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212615
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 212616
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212617
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212618
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212619
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 212620
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0