CMS Formulary

Displaying 189571-189580 of 1611142 results.
ID: 189571
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189572
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189573
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189574
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 189575
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 189576
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 189577
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 189578
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 189579
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 189580
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0