CMS Formulary

Displaying 214061-214070 of 1611142 results.
ID: 214061
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214062
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214063
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214064
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214065
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214066
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214067
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214068
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848956
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214069
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1596108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 214070
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0