CMS Formulary

Displaying 205911-205920 of 1611142 results.
ID: 205911
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205912
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205913
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 205914
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 205915
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 205916
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 205917
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205918
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205919
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205920
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0