CMS Formulary

Displaying 219731-219740 of 1611142 results.
ID: 219731
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219732
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219733
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219734
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 219735
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 219736
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 219737
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 219738
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 219739
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 219740
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30