CMS Formulary

Displaying 214631-214640 of 1611142 results.
ID: 214631
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214632
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214633
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214634
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214635
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214636
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214637
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1014673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214638
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214639
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214640
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30