CMS Formulary

Displaying 209141-209150 of 1611142 results.
ID: 209141
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209142
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209143
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209144
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209145
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209146
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209147
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209148
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209149
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 209150
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30