CMS Formulary

Displaying 209991-210000 of 1611142 results.
ID: 209991
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209992
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209993
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209994
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209995
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209996
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 209997
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 90
ID: 209998
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 209999
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 210000
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30