CMS Formulary

Displaying 189281-189290 of 1611142 results.
ID: 189281
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189282
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189283
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189284
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189285
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189286
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189287
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1014673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189288
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189289
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189290
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30