CMS Formulary

Displaying 194601-194610 of 1611142 results.
ID: 194601
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2371768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 194602
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 194603
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194604
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2166143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 194605
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2196900
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 194606
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 194607
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1940709
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 194608
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597388
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 194609
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194610
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0