CMS Formulary

Displaying 205761-205770 of 1611142 results.
ID: 205761
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 180
ID: 205762
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1541594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205763
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205764
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205765
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205766
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205767
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205768
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205769
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205770
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0