CMS Formulary

Displaying 217871-217880 of 1611142 results.
ID: 217871
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 217872
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 217873
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 217874
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 217875
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 217876
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 217877
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 217878
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 217879
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 217880
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0