CMS Formulary

Displaying 211321-211330 of 1611142 results.
ID: 211321
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211322
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211323
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 260376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 211324
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 857706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211325
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211326
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 328161
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211327
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211328
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211329
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211330
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0