CMS Formulary

Displaying 190551-190560 of 1611142 results.
ID: 190551
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 190552
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190553
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 190554
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190555
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190556
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190557
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190558
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190559
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 861568
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 190560
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 692576
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30