CMS Formulary

Displaying 208491-208500 of 1611142 results.
ID: 208491
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208492
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208493
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208494
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208495
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 849833
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208496
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 208497
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 208498
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208499
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208500
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0