CMS Formulary

Displaying 208351-208360 of 1611142 results.
ID: 208351
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208352
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208353
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208354
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208355
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208356
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208357
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208358
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 208359
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208360
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0