CMS Formulary

Displaying 209311-209320 of 1611142 results.
ID: 209311
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209312
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209313
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209314
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209315
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209316
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209317
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209318
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209319
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209320
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0