CMS Formulary

Displaying 207971-207980 of 1611142 results.
ID: 207971
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207972
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207973
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 207974
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207975
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 607295
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207976
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207977
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207978
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207979
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207980
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0