CMS Formulary

Displaying 189371-189380 of 1611142 results.
ID: 189371
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313995
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 189372
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189373
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189374
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189375
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189376
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189377
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189378
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 189379
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189380
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0