CMS Formulary

Displaying 188151-188160 of 1611142 results.
ID: 188151
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188152
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188153
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188154
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188155
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188156
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 188157
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188158
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188159
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188160
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0