CMS Formulary

Displaying 218731-218740 of 1611142 results.
ID: 218731
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218732
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 218733
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 218734
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 218735
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 218736
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 218737
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218738
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218739
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218740
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0