CMS Formulary

Displaying 193771-193780 of 1611142 results.
ID: 193771
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193772
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193773
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193774
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193775
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193776
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 485489
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193777
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193778
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193779
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 193780
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0