CMS Formulary

Displaying 194681-194690 of 1611142 results.
ID: 194681
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 194682
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 194683
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194684
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194685
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 194686
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1923829
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194687
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194688
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 194689
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1923827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194690
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1923825
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0