CMS Formulary

Displaying 214261-214270 of 1611142 results.
ID: 214261
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214262
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214263
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214264
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214265
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214266
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214267
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214268
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214269
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214270
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0