CMS Formulary

Displaying 205821-205830 of 1611142 results.
ID: 205821
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205822
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 205823
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205824
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205825
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205826
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205827
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205828
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 746804
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 205829
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 746815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 205830
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 746813
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30