CMS Formulary

Displaying 215241-215250 of 1611142 results.
ID: 215241
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215242
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1543177
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215243
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215244
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215245
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215246
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215247
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 215248
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215249
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215250
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0