CMS Formulary

Displaying 214681-214690 of 1611142 results.
ID: 214681
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214682
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214683
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214684
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 858778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 214685
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214686
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214687
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214688
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214689
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214690
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 206791
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0