CMS Formulary

Displaying 206681-206690 of 1611142 results.
ID: 206681
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206682
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206683
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206684
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206685
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206686
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1314768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 206687
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206688
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206689
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206690
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30