CMS Formulary

Displaying 188851-188860 of 1611142 results.
ID: 188851
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 188852
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188853
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188854
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188855
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188856
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188857
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188858
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1608276
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 188859
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1608274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188860
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0