CMS Formulary

Displaying 213341-213350 of 1611142 results.
ID: 213341
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 213342
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213343
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213344
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213345
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213346
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 213347
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 213348
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 213349
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 213350
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30