CMS Formulary

Displaying 207061-207070 of 1611142 results.
ID: 207061
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207062
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 207063
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 207064
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 904880
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 207065
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 207066
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 207067
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 207068
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 207069
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 207070
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30