CMS Formulary

Displaying 207011-207020 of 1611142 results.
ID: 207011
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 207012
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207013
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207014
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207015
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207016
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207017
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207018
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861822
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 207019
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207020
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0