CMS Formulary

Displaying 211391-211400 of 1611142 results.
ID: 211391
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 28
ID: 211392
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211393
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211394
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211395
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 308739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211396
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211397
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211398
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211399
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 30
ID: 211400
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30