CMS Formulary

Displaying 205561-205570 of 1611142 results.
ID: 205561
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205562
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205563
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 205564
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 205565
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205566
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205567
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205568
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205569
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205570
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30