CMS Formulary

Displaying 219591-219600 of 1611142 results.
ID: 219591
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219592
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219593
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219594
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219595
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219596
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 219597
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219598
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219599
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219600
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30