CMS Formulary

Displaying 218541-218550 of 1611142 results.
ID: 218541
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 218542
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218543
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218544
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218545
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 313416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218546
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218547
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218548
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218549
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218550
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0