CMS Formulary

Displaying 189381-189390 of 1611142 results.
ID: 189381
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189382
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189383
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189384
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189385
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189386
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189387
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189388
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 189389
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 900156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189390
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 848582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0