CMS Formulary

Displaying 193681-193690 of 1611142 results.
ID: 193681
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193682
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193683
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193684
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193685
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193686
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193687
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193688
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193689
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193690
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30