CMS Formulary

Displaying 188191-188200 of 1611142 results.
ID: 188191
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 188192
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 188193
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 828299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188194
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 188195
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188196
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 857564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188197
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188198
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188199
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188200
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0