CMS Formulary

Displaying 212091-212100 of 1611142 results.
ID: 212091
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212092
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 212093
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198116
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212094
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212095
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212096
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212097
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212098
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212099
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212100
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0