CMS Formulary

Displaying 213911-213920 of 1611142 results.
ID: 213911
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 213912
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213913
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213914
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213915
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213916
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213917
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1723156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213918
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213919
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213920
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0