CMS Formulary

Displaying 209391-209400 of 1611142 results.
ID: 209391
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209392
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 209393
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209394
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209395
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209396
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209397
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 209398
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 209399
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209400
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0