CMS Formulary

Displaying 208411-208420 of 1611142 results.
ID: 208411
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208412
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 730869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208413
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208414
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208415
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208416
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208417
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208418
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1922783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208419
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208420
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30