CMS Formulary

Displaying 206071-206080 of 1611142 results.
ID: 206071
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206072
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 903873
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206073
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 903879
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206074
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892342
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206075
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892349
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206076
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892355
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206077
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892297
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206078
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 894942
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206079
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 894970
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206080
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0