CMS Formulary

Displaying 208601-208610 of 1611142 results.
ID: 208601
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208602
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 310154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208603
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 208604
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208605
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208606
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208607
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208608
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 208609
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208610
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0