CMS Formulary

Displaying 206551-206560 of 1611142 results.
ID: 206551
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 206552
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 206553
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206554
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206555
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206556
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206557
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206558
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 206559
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 206560
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0