CMS Formulary

Displaying 213031-213040 of 1611142 results.
ID: 213031
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 213032
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 213033
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 213034
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 213035
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213036
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213037
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213038
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213039
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213040
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28