CMS Formulary

Displaying 192251-192260 of 1611142 results.
ID: 192251
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192252
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192253
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 808118
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192254
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192255
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192256
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192257
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 192258
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192259
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192260
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0