CMS Formulary

Displaying 213631-213640 of 1611142 results.
ID: 213631
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213632
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 213633
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1657173
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 213634
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 213635
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213636
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 213637
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213638
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213639
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213640
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0