CMS Formulary

Displaying 208561-208570 of 1611142 results.
ID: 208561
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208562
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208563
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208564
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208565
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 853201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208566
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208567
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208568
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208569
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208570
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0