CMS Formulary

Displaying 216041-216050 of 1611142 results.
ID: 216041
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 216042
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216043
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216044
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216045
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216046
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216047
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 216048
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 216049
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 216050
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30