CMS Formulary

Displaying 189341-189350 of 1611142 results.
ID: 189341
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 580286
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189342
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2107351
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189343
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2107355
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189344
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597570
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189345
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1864414
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189346
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1431083
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189347
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1666385
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189348
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1431104
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189349
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189350
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0