CMS Formulary

Displaying 209481-209490 of 1611142 results.
ID: 209481
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209482
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209483
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209484
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209485
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209486
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 209487
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 209488
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 209489
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209490
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0