CMS Formulary

Displaying 215251-215260 of 1611142 results.
ID: 215251
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215252
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197940
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215253
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215254
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215255
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215256
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215257
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215258
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215259
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 476345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 215260
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 476349
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30