CMS Formulary

Displaying 207041-207050 of 1611142 results.
ID: 207041
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207042
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 207043
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207044
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207045
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 984105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207046
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207047
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207048
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207049
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207050
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 794979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0