CMS Formulary

Displaying 206741-206750 of 1611142 results.
ID: 206741
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206742
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206743
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206744
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206745
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206746
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206747
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206748
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206749
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206750
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30