CMS Formulary

Displaying 207071-207080 of 1611142 results.
ID: 207071
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207072
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207073
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207074
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207075
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207076
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207077
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 207078
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 207079
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207080
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0