CMS Formulary

Displaying 210471-210480 of 1611142 results.
ID: 210471
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210472
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210473
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 861822
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 210474
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210475
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210476
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210477
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210478
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210479
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210480
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0