CMS Formulary

Displaying 191991-192000 of 1611142 results.
ID: 191991
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191992
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191993
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191994
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 191995
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191996
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191997
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 191998
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 191999
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192000
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0