CMS Formulary

Displaying 215661-215670 of 1611142 results.
ID: 215661
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 10
ID: 215662
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 10
ID: 215663
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215664
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215665
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215666
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215667
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215668
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215669
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 616402
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 215670
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0