CMS Formulary

Displaying 212761-212770 of 1611142 results.
ID: 212761
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212762
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212763
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212764
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 825429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212765
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 884619
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212766
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2121061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 212767
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1656356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 212768
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212769
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212770
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0