CMS Formulary

Displaying 203701-203710 of 1611142 results.
ID: 203701
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203702
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203703
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203704
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203705
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203706
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 203707
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 203708
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203709
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203710
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0