CMS Formulary

Displaying 193091-193100 of 1611142 results.
ID: 193091
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 193092
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193093
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193094
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 193095
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193096
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193097
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193098
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193099
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 849831
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193100
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 849835
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30