CMS Formulary

Displaying 208571-208580 of 1611142 results.
ID: 208571
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208572
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208573
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208574
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 826612
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208575
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208576
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208577
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208578
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208579
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208580
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30