CMS Formulary

Displaying 207301-207310 of 1611142 results.
ID: 207301
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207302
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207303
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207304
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207305
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 207306
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207307
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207308
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 207309
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 207310
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0