CMS Formulary

Displaying 187951-187960 of 1611142 results.
ID: 187951
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 187952
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187953
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187954
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1855389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187955
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 728550
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 187956
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187957
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187958
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187959
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187960
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0