CMS Formulary

Displaying 208671-208680 of 1611142 results.
ID: 208671
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208672
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208673
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208674
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208675
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208676
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208677
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208678
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208679
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208680
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30