CMS Formulary

Displaying 207161-207170 of 1611142 results.
ID: 207161
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207162
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207163
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207164
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207165
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1608276
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 207166
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1608274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207167
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207168
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207169
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797883
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207170
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0