CMS Formulary

Displaying 212921-212930 of 1611142 results.
ID: 212921
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212922
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212923
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212924
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212925
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212926
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 212927
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212928
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212929
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212930
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0