CMS Formulary

Displaying 193261-193270 of 1611142 results.
ID: 193261
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 193262
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 193263
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 193264
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 485486
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193265
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 485485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193266
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 485484
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193267
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193268
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 193269
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193270
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0