CMS Formulary

Displaying 205571-205580 of 1611142 results.
ID: 205571
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205572
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205573
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205574
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205575
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205576
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205577
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205578
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205579
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205580
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0