CMS Formulary

Displaying 211381-211390 of 1611142 results.
ID: 211381
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211382
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211383
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 211384
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 211385
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211386
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211387
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 211388
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 211389
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 211390
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0