CMS Formulary

Displaying 213841-213850 of 1611142 results.
ID: 213841
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213842
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213843
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213844
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213845
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213846
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213847
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213848
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213849
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213850
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0