CMS Formulary

Displaying 210431-210440 of 1611142 results.
ID: 210431
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210432
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210433
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210434
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 210435
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 210436
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210437
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210438
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210439
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210440
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0