CMS Formulary

Displaying 194391-194400 of 1611142 results.
ID: 194391
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205826
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194392
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1011987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194393
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856935
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194394
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 25
ID: 194395
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 864820
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 194396
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 486155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 194397
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310173
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 194398
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1149645
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 194399
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 194400
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1190955
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30