CMS Formulary

Displaying 209791-209800 of 1611142 results.
ID: 209791
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 209792
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 209793
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 209794
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 209795
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 209796
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 209797
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 209798
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 209799
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209800
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0