CMS Formulary

Displaying 209271-209280 of 1611142 results.
ID: 209271
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209272
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209273
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209274
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 209275
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209276
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209277
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 209278
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209279
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209280
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0