CMS Formulary

Displaying 206251-206260 of 1611142 results.
ID: 206251
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206252
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206253
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206254
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 618552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206255
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206256
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206257
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206258
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 206259
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 206260
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28