CMS Formulary

Displaying 193801-193810 of 1611142 results.
ID: 193801
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193802
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 849833
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 193803
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 193804
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 193805
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193806
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193807
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193808
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193809
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 859081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193810
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486691
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0