CMS Formulary

Displaying 190861-190870 of 1611142 results.
ID: 190861
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190862
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190863
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190864
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 153579
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190865
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 153580
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190866
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 190867
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 190868
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 190869
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190870
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0