CMS Formulary

Displaying 209871-209880 of 1611142 results.
ID: 209871
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209872
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209873
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209874
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209875
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28
ID: 209876
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209877
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209878
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209879
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209880
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0