CMS Formulary

Displaying 213191-213200 of 1611142 results.
ID: 213191
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 207391
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213192
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213193
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213194
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 801405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213195
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213196
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213197
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213198
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 213199
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 213200
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0