CMS Formulary

Displaying 192231-192240 of 1611142 results.
ID: 192231
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192232
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192233
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 192234
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192235
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192236
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192237
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192238
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192239
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 406524
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192240
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 434018
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0