CMS Formulary

Displaying 213211-213220 of 1611142 results.
ID: 213211
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213212
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213213
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213214
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213215
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213216
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213217
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213218
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 30
ID: 213219
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213220
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0