CMS Formulary

Displaying 189881-189890 of 1611142 results.
ID: 189881
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189882
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189883
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189884
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189885
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189886
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189887
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 189888
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189889
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189890
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0