CMS Formulary

Displaying 209091-209100 of 1611142 results.
ID: 209091
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 209092
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 209093
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209094
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209095
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 209096
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 209097
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209098
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209099
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209100
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0