CMS Formulary

Displaying 206481-206490 of 1611142 results.
ID: 206481
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 206482
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206483
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206484
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206485
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206486
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206487
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206488
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206489
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206490
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30