CMS Formulary

Displaying 214971-214980 of 1611142 results.
ID: 214971
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214972
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214973
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214974
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214975
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 214976
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214977
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214978
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214979
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214980
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30