CMS Formulary

Displaying 194371-194380 of 1611142 results.
ID: 194371
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194372
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194373
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194374
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194375
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 882533
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194376
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194377
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848330
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 90
ID: 194378
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194379
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194380
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 762833
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0