CMS Formulary

Displaying 195081-195090 of 1611142 results.
ID: 195081
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 832718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195082
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195083
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195084
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195085
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 30
ID: 195086
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195087
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 195088
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195089
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195090
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0