CMS Formulary

Displaying 208301-208310 of 1611142 results.
ID: 208301
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 208302
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 208303
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 208304
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 208305
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 208306
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 208307
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873765
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208308
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 208309
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 208310
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0