CMS Formulary

Displaying 207081-207090 of 1611142 results.
ID: 207081
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207082
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207083
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207084
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207085
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 856987
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 207086
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 856992
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 207087
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 311989
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207088
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207089
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207090
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0