CMS Formulary

Displaying 215851-215860 of 1611142 results.
ID: 215851
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215852
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215853
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215854
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1053697
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 215855
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215856
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 215857
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215858
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215859
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215860
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0