CMS Formulary

Displaying 209781-209790 of 1611142 results.
ID: 209781
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 209782
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 209783
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 209784
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 209785
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209786
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209787
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209788
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209789
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 209790
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30