CMS Formulary

Displaying 205941-205950 of 1611142 results.
ID: 205941
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205942
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 205943
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 205944
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205945
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205946
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205947
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 205948
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205949
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205950
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30