CMS Formulary

Displaying 205991-206000 of 1611142 results.
ID: 205991
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205992
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205993
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205994
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205995
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5550
Qty Limit Days: 30
ID: 205996
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205997
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205998
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205999
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206000
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0