CMS Formulary

Displaying 189681-189690 of 1611142 results.
ID: 189681
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189682
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189683
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189684
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189685
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189686
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189687
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189688
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189689
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189690
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0