CMS Formulary

Displaying 205831-205840 of 1611142 results.
ID: 205831
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 790284
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 205832
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2196792
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 205833
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2196592
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 205834
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1536144
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 205835
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1536148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 205836
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205837
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205838
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205839
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1246313
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 205840
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1246310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30