CMS Formulary

Displaying 193561-193570 of 1611142 results.
ID: 193561
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193562
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193563
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 193564
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193565
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193566
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 193567
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 193568
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 193569
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 193570
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30