CMS Formulary

Displaying 198881-198890 of 1611142 results.
ID: 198881
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 198882
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 53
Qty Limit Days: 28
ID: 198883
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198884
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198885
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198886
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198887
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198888
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198889
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198890
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0