CMS Formulary

Displaying 211-220 of 1611142 results.
ID: 211
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 804547
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 216
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 217
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 218
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 219
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 220
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28