CMS Formulary

Displaying 208871-208880 of 1611142 results.
ID: 208871
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045959
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208872
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045961
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208873
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045958
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208874
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2059189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208875
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 208876
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 208877
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 208878
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 208879
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 208880
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30