CMS Formulary

Displaying 194711-194720 of 1611142 results.
ID: 194711
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 746815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 194712
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 746813
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 194713
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 790284
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 194714
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2196792
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 194715
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2196592
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 194716
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1536144
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 194717
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1536148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 194718
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194719
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194720
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0