CMS Formulary

Displaying 207961-207970 of 1611142 results.
ID: 207961
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207962
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207963
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 207964
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 207965
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207966
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207967
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207968
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207969
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207970
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0