CMS Formulary

Displaying 206631-206640 of 1611142 results.
ID: 206631
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206632
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 206633
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206634
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 206635
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 206636
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 206637
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 206638
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 206639
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 388525
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 30
ID: 206640
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 360507
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30