CMS Formulary

Displaying 219191-219200 of 1611142 results.
ID: 219191
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219192
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219193
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219194
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219195
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 219196
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219197
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219198
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1247381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219199
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219200
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0