CMS Formulary

Displaying 215741-215750 of 1611142 results.
ID: 215741
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215742
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215743
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 215744
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 215745
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215746
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215747
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215748
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215749
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215750
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0