CMS Formulary

Displaying 192461-192470 of 1611142 results.
ID: 192461
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 192462
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192463
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192464
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192465
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192466
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430122
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192467
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192468
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192469
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192470
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0