CMS Formulary

Displaying 208681-208690 of 1611142 results.
ID: 208681
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208682
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208683
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208684
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897781
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208685
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208686
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 897844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208687
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208688
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208689
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208690
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30