CMS Formulary

Displaying 201071-201080 of 1611142 results.
ID: 201071
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201072
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201073
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 201074
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 201075
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201076
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201077
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201078
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201079
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201080
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0