CMS Formulary

Displaying 214281-214290 of 1611142 results.
ID: 214281
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214282
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214283
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214284
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214285
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214286
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 903847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214287
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214288
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214289
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214290
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1860491
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30