CMS Formulary

Displaying 213621-213630 of 1611142 results.
ID: 213621
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213622
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213623
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213624
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213625
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213626
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213627
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213628
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213629
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213630
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0