CMS Formulary

Displaying 215931-215940 of 1611142 results.
ID: 215931
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 215932
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215933
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310155
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215934
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 315090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215935
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310157
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215936
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215937
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 215938
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215939
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215940
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0