CMS Formulary

Displaying 215781-215790 of 1611142 results.
ID: 215781
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215782
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215783
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 284201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 215784
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 351134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 215785
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 314142
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 215786
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 215787
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215788
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215789
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215790
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988319
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0