CMS Formulary

Displaying 193791-193800 of 1611142 results.
ID: 193791
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193792
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193793
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 193794
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 193795
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193796
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193797
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193798
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 629699
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193799
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 629695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193800
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 629697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0