CMS Formulary

Displaying 214561-214570 of 1611142 results.
ID: 214561
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 896110
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 214562
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214563
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1246096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 214564
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214565
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214566
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214567
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214568
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214569
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214570
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0