CMS Formulary

Displaying 190381-190390 of 1611142 results.
ID: 190381
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 190382
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190383
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 190384
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190385
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190386
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190387
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190388
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 310154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190389
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 190390
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30