CMS Formulary

Displaying 208621-208630 of 1611142 results.
ID: 208621
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208622
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208623
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208624
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208625
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208626
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208627
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 208628
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208629
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208630
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30