CMS Formulary

Displaying 191891-191900 of 1611142 results.
ID: 191891
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191892
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191893
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 285
Qty Limit Days: 28
ID: 191894
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 191895
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 191896
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 191897
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 26
Qty Limit Days: 30
ID: 191898
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 191899
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191900
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30