CMS Formulary

Displaying 188621-188630 of 1611142 results.
ID: 188621
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188622
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 188623
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 188624
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188625
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188626
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188627
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188628
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188629
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1043025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188630
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1043031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0