CMS Formulary

Displaying 194761-194770 of 1611142 results.
ID: 194761
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194762
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194763
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194764
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194765
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194766
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194767
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194768
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194769
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194770
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0