CMS Formulary

Displaying 189161-189170 of 1611142 results.
ID: 189161
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189162
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189163
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189164
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189165
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189166
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189167
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189168
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189169
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189170
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30