CMS Formulary

Displaying 218341-218350 of 1611142 results.
ID: 218341
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 218342
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218343
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 218344
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218345
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218346
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218347
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218348
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218349
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218350
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0