CMS Formulary

Displaying 216661-216670 of 1611142 results.
ID: 216661
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 216662
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 216663
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 216664
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 216665
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 216666
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 216667
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 216668
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 216669
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216670
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0