CMS Formulary

Displaying 189181-189190 of 1611142 results.
ID: 189181
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 189182
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 189183
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 189184
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 189185
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 189186
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 189187
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 189188
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1286
Qty Limit Days: 30
ID: 189189
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189190
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28