CMS Formulary

Displaying 209851-209860 of 1611142 results.
ID: 209851
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209852
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 209853
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209854
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 209855
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209856
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209857
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209858
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209859
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209860
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0