CMS Formulary

Displaying 191761-191770 of 1611142 results.
ID: 191761
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191762
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 191763
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191764
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191765
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191766
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 191767
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191768
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 191769
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 191770
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806191
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30