CMS Formulary

Displaying 188861-188870 of 1611142 results.
ID: 188861
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188862
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797883
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 188863
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188864
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188865
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 141859
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 188866
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 126
Qty Limit Days: 28
ID: 188867
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188868
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188869
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188870
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0