CMS Formulary

Displaying 214731-214740 of 1611142 results.
ID: 214731
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214732
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214733
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214734
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214735
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214736
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214737
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214738
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 214739
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 900156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214740
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 848582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0