CMS Formulary

Displaying 192221-192230 of 1611142 results.
ID: 192221
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192222
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192223
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192224
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 192225
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 192226
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192227
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192228
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192229
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192230
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0