CMS Formulary

Displaying 219661-219670 of 1611142 results.
ID: 219661
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219662
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 856656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219663
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 856660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219664
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 856652
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219665
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 219666
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219667
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219668
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219669
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219670
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0