CMS Formulary

Displaying 191181-191190 of 1611142 results.
ID: 191181
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191182
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191183
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191184
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 757707
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 191185
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 403957
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 191186
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191187
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191188
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191189
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 191190
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0