CMS Formulary

Displaying 193081-193090 of 1611142 results.
ID: 193081
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193082
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193083
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193084
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193085
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193086
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 193087
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 193088
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 193089
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 193090
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28