CMS Formulary

Displaying 189351-189360 of 1611142 results.
ID: 189351
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189352
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189353
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1433736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 189354
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189355
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189356
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189357
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189358
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189359
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189360
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0