CMS Formulary

Displaying 193841-193850 of 1611142 results.
ID: 193841
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193842
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 193843
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 193844
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 193845
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 193846
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193847
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 193848
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 193849
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193850
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0