CMS Formulary

Displaying 213851-213860 of 1611142 results.
ID: 213851
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213852
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213853
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213854
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213855
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213856
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213857
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 213858
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213859
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213860
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0