CMS Formulary

Displaying 208171-208180 of 1611142 results.
ID: 208171
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208172
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208173
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208174
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208175
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208176
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208177
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208178
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 208179
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 208180
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28