CMS Formulary

Displaying 190451-190460 of 1611142 results.
ID: 190451
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190452
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190453
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190454
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 190455
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190456
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190457
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190458
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190459
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190460
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0