CMS Formulary

Displaying 193031-193040 of 1611142 results.
ID: 193031
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 193032
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 193033
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193034
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193035
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193036
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193037
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193038
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193039
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193040
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0