CMS Formulary

Displaying 212061-212070 of 1611142 results.
ID: 212061
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212062
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 212063
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 212064
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212065
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212066
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212067
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212068
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212069
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212070
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0