CMS Formulary

Displaying 211581-211590 of 1611142 results.
ID: 211581
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211582
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211583
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197940
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211584
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211585
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211586
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211587
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211588
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211589
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211590
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 476345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30