CMS Formulary

Displaying 214181-214190 of 1611142 results.
ID: 214181
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214182
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214183
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214184
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214185
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214186
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 252479
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214187
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 248642
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214188
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 214189
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214190
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30