CMS Formulary

Displaying 189961-189970 of 1611142 results.
ID: 189961
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 189962
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189963
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189964
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 309140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189965
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189966
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189967
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1658221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189968
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189969
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 189970
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0