CMS Formulary

Displaying 208511-208520 of 1611142 results.
ID: 208511
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486691
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208512
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111020
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208513
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653221
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208514
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208515
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 208516
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208517
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208518
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208519
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208520
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0