CMS Formulary

Displaying 206871-206880 of 1611142 results.
ID: 206871
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206872
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206873
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206874
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 206875
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 206876
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 206877
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 206878
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206879
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206880
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0