CMS Formulary

Displaying 216621-216630 of 1611142 results.
ID: 216621
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216622
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216623
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216624
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216625
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216626
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 216627
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216628
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 216629
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 216630
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30