CMS Formulary

Displaying 213201-213210 of 1611142 results.
ID: 213201
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213202
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213203
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 213204
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213205
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213206
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213207
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213208
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213209
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213210
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0