CMS Formulary

Displaying 192301-192310 of 1611142 results.
ID: 192301
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 856980
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 192302
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192303
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192304
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192305
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192306
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192307
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192308
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192309
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192310
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0