CMS Formulary

Displaying 192861-192870 of 1611142 results.
ID: 192861
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192862
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192863
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192864
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192865
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192866
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 192867
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 192868
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192869
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 192870
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0