CMS Formulary

Displaying 209971-209980 of 1611142 results.
ID: 209971
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 209972
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 209973
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 828299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209974
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 209975
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209976
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 857564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209977
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209978
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209979
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209980
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0