CMS Formulary

Displaying 206201-206210 of 1611142 results.
ID: 206201
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206202
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206203
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206204
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206205
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206206
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 30
ID: 206207
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206208
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206209
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206210
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197318
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0