CMS Formulary

Displaying 208291-208300 of 1611142 results.
ID: 208291
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208292
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208293
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208294
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 208295
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208296
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208297
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208298
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208299
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208300
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 280
Qty Limit Days: 28