CMS Formulary

Displaying 194861-194870 of 1611142 results.
ID: 194861
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194862
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194863
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194864
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194865
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194866
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 359493
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 194867
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 359494
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 194868
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194869
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194870
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0