CMS Formulary

Displaying 219261-219270 of 1611142 results.
ID: 219261
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219262
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219263
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219264
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219265
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 219266
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219267
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219268
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219269
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219270
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30