CMS Formulary

Displaying 206791-206800 of 1611142 results.
ID: 206791
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206792
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206793
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206794
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206795
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206796
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206797
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206798
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206799
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206800
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1000
Qty Limit Days: 28