CMS Formulary

Displaying 218241-218250 of 1611142 results.
ID: 218241
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 30
ID: 218242
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 218243
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 218244
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1052660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 218245
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1250723
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 218246
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 218247
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 218248
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218249
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218250
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0