CMS Formulary

Displaying 205631-205640 of 1611142 results.
ID: 205631
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205632
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205633
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205634
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205635
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205636
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 205637
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 205638
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205639
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205640
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30