CMS Formulary

Displaying 215401-215410 of 1611142 results.
ID: 215401
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215402
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215403
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215404
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 215405
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 215406
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 215407
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 215408
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215409
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215410
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0