CMS Formulary

Displaying 213291-213300 of 1611142 results.
ID: 213291
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213292
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 208327
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213293
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213294
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213295
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213296
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213297
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213298
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213299
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213300
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30