CMS Formulary

Displaying 188361-188370 of 1611142 results.
ID: 188361
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188362
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188363
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188364
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 188365
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 188366
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 188367
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1314768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 188368
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 211777
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188369
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188370
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0