CMS Formulary

Displaying 192201-192210 of 1611142 results.
ID: 192201
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192202
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 485023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192203
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192204
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192205
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 485020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192206
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192207
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192208
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 192209
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 192210
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0