CMS Formulary

Displaying 213871-213880 of 1611142 results.
ID: 213871
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213872
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213873
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213874
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213875
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213876
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213877
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 485023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213878
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 213879
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213880
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 485020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0