CMS Formulary

Displaying 193661-193670 of 1611142 results.
ID: 193661
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193662
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193663
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193664
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193665
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193666
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 193667
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193668
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193669
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193670
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 433798
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0