CMS Formulary

Displaying 190081-190090 of 1611142 results.
ID: 190081
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 190082
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190083
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 280
Qty Limit Days: 28
ID: 190084
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 190085
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 190086
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 190087
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 190088
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 190089
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 190090
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873765
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0