CMS Formulary

Displaying 219611-219620 of 1611142 results.
ID: 219611
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219612
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 219613
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219614
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219615
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219616
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219617
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219618
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219619
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219620
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0