CMS Formulary

Displaying 189621-189630 of 1611142 results.
ID: 189621
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189622
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189623
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189624
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189625
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 189626
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189627
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189628
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189629
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189630
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30