CMS Formulary

Displaying 215351-215360 of 1611142 results.
ID: 215351
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215352
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215353
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215354
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215355
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 215356
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 215357
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 215358
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 215359
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 215360
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0