CMS Formulary

Displaying 206751-206760 of 1611142 results.
ID: 206751
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206752
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206753
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206754
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 730866
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206755
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206756
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206757
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206758
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206759
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206760
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0