CMS Formulary

Displaying 209181-209190 of 1611142 results.
ID: 209181
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 209182
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 209183
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209184
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209185
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209186
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209187
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209188
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209189
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209190
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0