CMS Formulary

Displaying 206411-206420 of 1611142 results.
ID: 206411
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206412
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206413
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206414
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206415
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 206416
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206417
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206418
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206419
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206420
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28