CMS Formulary

Displaying 195061-195070 of 1611142 results.
ID: 195061
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 485416
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195062
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195063
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 904571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195064
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195065
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195066
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195067
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 835958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195068
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195069
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195070
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0