CMS Formulary

Displaying 189741-189750 of 1611142 results.
ID: 189741
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189742
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189743
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 189744
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189745
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 607295
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189746
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189747
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189748
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189749
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189750
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0