CMS Formulary

Displaying 213141-213150 of 1611142 results.
ID: 213141
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1043582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213142
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1043574
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213143
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213144
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213145
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213146
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213147
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213148
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213149
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213150
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 847917
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30