CMS Formulary

Displaying 214801-214810 of 1611142 results.
ID: 214801
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214802
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214803
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214804
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214805
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214806
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214807
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214808
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214809
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214810
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0