CMS Formulary

Displaying 213121-213130 of 1611142 results.
ID: 213121
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213122
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213123
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 207273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213124
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213125
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213126
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213127
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213128
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213129
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 213130
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30