CMS Formulary

Displaying 208851-208860 of 1611142 results.
ID: 208851
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208852
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208853
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208854
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208855
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208856
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208857
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208858
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1673373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208859
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208860
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1011712
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0