CMS Formulary

Displaying 189581-189590 of 1611142 results.
ID: 189581
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189582
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189583
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189584
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189585
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189586
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 189587
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189588
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189589
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 30
ID: 189590
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30