CMS Formulary

Displaying 212731-212740 of 1611142 results.
ID: 212731
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212732
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212733
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 212734
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 212735
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 180
ID: 212736
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 212737
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212738
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212739
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 212957
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212740
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0