CMS Formulary

Displaying 190961-190970 of 1611142 results.
ID: 190961
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 190962
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 978737
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 190963
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 978757
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 190964
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 978741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 190965
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 978745
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 190966
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190967
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 978747
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 30
ID: 190968
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 190969
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 978778
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 190970
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0