CMS Formulary

Displaying 193821-193830 of 1611142 results.
ID: 193821
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193822
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193823
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193824
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193825
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193826
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193827
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193828
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 193829
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 616402
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193830
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0