CMS Formulary

Displaying 208191-208200 of 1611142 results.
ID: 208191
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208192
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1658221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208193
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208194
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 208195
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208196
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208197
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208198
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208199
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208200
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0