CMS Formulary

Displaying 219081-219090 of 1611142 results.
ID: 219081
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219082
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 198037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219083
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219084
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219085
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219086
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219087
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 219088
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 219089
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 219090
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0