CMS Formulary

Displaying 194841-194850 of 1611142 results.
ID: 194841
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194842
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194843
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194844
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194845
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194846
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 194847
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194848
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 194849
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194850
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30