CMS Formulary

Displaying 202091-202100 of 1611142 results.
ID: 202091
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202092
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202093
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202094
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 202095
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 202096
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 202097
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 202098
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 202099
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202100
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1