CMS Formulary

Displaying 189481-189490 of 1611142 results.
ID: 189481
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 189482
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 189483
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 189484
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189485
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189486
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189487
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189488
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189489
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189490
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30