CMS Formulary

Displaying 207701-207710 of 1611142 results.
ID: 207701
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 966214
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207702
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 207703
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 55
Qty Limit Days: 28
ID: 207704
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 207705
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207706
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207707
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207708
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207709
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 858125
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207710
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 858127
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0