CMS Formulary

Displaying 215451-215460 of 1611142 results.
ID: 215451
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215452
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 215453
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 215454
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215455
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215456
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215457
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215458
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215459
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215460
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0