CMS Formulary

Displaying 189151-189160 of 1611142 results.
ID: 189151
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189152
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189153
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189154
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189155
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189156
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189157
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189158
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189159
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 861353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 189160
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0