CMS Formulary

Displaying 189501-189510 of 1611142 results.
ID: 189501
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189502
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189503
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 189504
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189505
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189506
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189507
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189508
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189509
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189510
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0