CMS Formulary

Displaying 188751-188760 of 1611142 results.
ID: 188751
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188752
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188753
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188754
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188755
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 188756
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 188757
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 904880
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 188758
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 188759
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 188760
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30