CMS Formulary

Displaying 192121-192130 of 1611142 results.
ID: 192121
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192122
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192123
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192124
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192125
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192126
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192127
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 730866
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192128
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192129
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192130
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0