CMS Formulary

Displaying 205401-205410 of 1611142 results.
ID: 205401
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205402
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205403
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 307732
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205404
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205405
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1493276
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205406
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2055286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205407
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 205408
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205409
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 205410
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28