CMS Formulary

Displaying 194721-194730 of 1611142 results.
ID: 194721
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1246313
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 194722
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1246310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 194723
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194724
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194725
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194726
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194727
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194728
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194729
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194730
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0