CMS Formulary

Displaying 213861-213870 of 1611142 results.
ID: 213861
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 213862
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 213863
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 213864
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 213865
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 213866
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213867
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213868
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213869
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213870
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0