CMS Formulary

Displaying 208931-208940 of 1611142 results.
ID: 208931
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208932
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208933
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 208934
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 208935
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 208936
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1247381
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208937
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208938
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208939
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208940
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 198050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0