CMS Formulary

Displaying 209201-209210 of 1611142 results.
ID: 209201
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 209202
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 180
ID: 209203
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 209204
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209205
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 209206
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209207
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209208
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209209
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 30
ID: 209210
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28