CMS Formulary

Displaying 188311-188320 of 1611142 results.
ID: 188311
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188312
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188313
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 188314
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188315
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 188316
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 188317
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 188318
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 188319
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 188320
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 388525
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 30