CMS Formulary

Displaying 189461-189470 of 1611142 results.
ID: 189461
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189462
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189463
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189464
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189465
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 189466
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 189467
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 189468
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 189469
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 189470
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30