CMS Formulary

Displaying 189811-189820 of 1611142 results.
ID: 189811
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1242611
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189812
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1242613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189813
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189814
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189815
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189816
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189817
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189818
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189819
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189820
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30