CMS Formulary

Displaying 194611-194620 of 1611142 results.
ID: 194611
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194612
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194613
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194614
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194615
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194616
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194617
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194618
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 966271
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194619
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 194620
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28