CMS Formulary

Displaying 204371-204380 of 1611142 results.
ID: 204371
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 204372
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 204373
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 204374
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 204375
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204376
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204377
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204378
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204379
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204380
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0