CMS Formulary

Displaying 207511-207520 of 1611142 results.
ID: 207511
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 896110
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 207512
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207513
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1246096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 207514
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207515
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 207516
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207517
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 308979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207518
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207519
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207520
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0