CMS Formulary

Displaying 190171-190180 of 1611142 results.
ID: 190171
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190172
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190173
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190174
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190175
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 190176
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190177
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190178
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190179
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190180
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0