CMS Formulary

Displaying 206501-206510 of 1611142 results.
ID: 206501
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 206502
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1375948
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206503
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 206504
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1596781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 206505
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206506
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206507
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206508
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206509
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206510
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0