CMS Formulary

Displaying 209191-209200 of 1611142 results.
ID: 209191
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209192
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209193
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209194
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209195
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 209196
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 209197
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209198
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209199
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855871
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209200
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 180