CMS Formulary

Displaying 206141-206150 of 1611142 results.
ID: 206141
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206142
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206143
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206144
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 847917
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 206145
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 847913
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 206146
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1990869
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 206147
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206148
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1729511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206149
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206150
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648999
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0