CMS Formulary

Displaying 210321-210330 of 1611142 results.
ID: 210321
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210322
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210323
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210324
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 210325
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 210326
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210327
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210328
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210329
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 210330
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30