CMS Formulary

Displaying 212881-212890 of 1611142 results.
ID: 212881
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 212882
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 212883
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212884
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212885
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212886
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212887
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212888
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212889
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212890
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0