CMS Formulary

Displaying 219181-219190 of 1611142 results.
ID: 219181
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 966177
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219182
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 966182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219183
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 966187
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219184
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 2104866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219185
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 966196
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219186
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 966202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219187
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 966207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219188
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 219189
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 219190
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28