CMS Formulary

Displaying 187721-187730 of 1611142 results.
ID: 187721
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1098608
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187722
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187723
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187724
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187725
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187726
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187727
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 903873
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187728
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 903879
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187729
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 892342
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187730
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 892349
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30