CMS Formulary

Displaying 191611-191620 of 1611142 results.
ID: 191611
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191612
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191613
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191614
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191615
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 191616
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191617
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 191618
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191619
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 404058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191620
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 404061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0