CMS Formulary

Displaying 208341-208350 of 1611142 results.
ID: 208341
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208342
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208343
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208344
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208345
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208346
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208347
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208348
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208349
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208350
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0