CMS Formulary

Displaying 218941-218950 of 1611142 results.
ID: 218941
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 218942
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 218943
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218944
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 218945
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 218946
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218947
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218948
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 218949
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 218950
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0