CMS Formulary

Displaying 188711-188720 of 1611142 results.
ID: 188711
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188712
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188713
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188714
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188715
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188716
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188717
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188718
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 848956
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188719
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1596108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 188720
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0