CMS Formulary

Displaying 189201-189210 of 1611142 results.
ID: 189201
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 189202
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189203
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 85
Qty Limit Days: 28
ID: 189204
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189205
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 189206
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189207
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189208
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189209
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 861505
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 118
Qty Limit Days: 28
ID: 189210
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 312139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28