CMS Formulary

Displaying 194881-194890 of 1611142 results.
ID: 194881
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194882
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194883
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194884
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194885
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194886
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194887
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1870230
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 194888
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1870225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 194889
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 194890
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0