CMS Formulary

Displaying 209641-209650 of 1611142 results.
ID: 209641
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 209642
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 209643
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209644
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209645
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209646
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 209647
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209648
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209649
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209650
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0