CMS Formulary

Displaying 207091-207100 of 1611142 results.
ID: 207091
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 608623
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207092
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 608624
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207093
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207094
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 207095
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207096
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207097
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207098
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207099
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300272
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 207100
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1541099
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 236
Qty Limit Days: 28