CMS Formulary

Displaying 213571-213580 of 1611142 results.
ID: 213571
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213572
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213573
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213574
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213575
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213576
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213577
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213578
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213579
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 213580
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30