CMS Formulary

Displaying 193751-193760 of 1611142 results.
ID: 193751
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193752
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193753
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193754
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193755
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 647237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193756
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 647239
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193757
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 643123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193758
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 643125
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193759
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 643127
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193760
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0