CMS Formulary

Displaying 208451-208460 of 1611142 results.
ID: 208451
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 647237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208452
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 647239
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208453
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208454
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198312
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208455
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 833461
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 30
ID: 208456
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208457
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208458
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1490032
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208459
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1490036
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208460
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1490040
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0