CMS Formulary

Displaying 209111-209120 of 1611142 results.
ID: 209111
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209112
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209113
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1304979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209114
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 209115
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209116
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209117
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209118
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 209119
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209120
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30