CMS Formulary

Displaying 206951-206960 of 1611142 results.
ID: 206951
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206952
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 206953
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 206954
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206955
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206956
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206957
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206958
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206959
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206960
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0