CMS Formulary

Displaying 213281-213290 of 1611142 results.
ID: 213281
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 213282
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 213283
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 213284
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 213285
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213286
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213287
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 966787
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213288
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 966793
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213289
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213290
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0