CMS Formulary

Displaying 192371-192380 of 1611142 results.
ID: 192371
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192372
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192373
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192374
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192375
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192376
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861822
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 192377
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 901541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192378
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192379
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 901534
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192380
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30