CMS Formulary

Displaying 212871-212880 of 1611142 results.
ID: 212871
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212872
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212873
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212874
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212875
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212876
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212877
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212878
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 212879
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 800915
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212880
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28