CMS Formulary

Displaying 218181-218190 of 1611142 results.
ID: 218181
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218182
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218183
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218184
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218185
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 218186
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 218187
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 218188
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 218189
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 218190
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28