CMS Formulary

Displaying 213511-213520 of 1611142 results.
ID: 213511
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213512
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213513
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213514
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213515
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 213516
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 213517
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 213518
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213519
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213520
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0