CMS Formulary

Displaying 192771-192780 of 1611142 results.
ID: 192771
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192772
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192773
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192774
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 192775
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192776
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192777
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192778
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192779
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192780
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0