CMS Formulary

Displaying 206191-206200 of 1611142 results.
ID: 206191
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 206192
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206193
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206194
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206195
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206196
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206197
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206198
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206199
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206200
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0