CMS Formulary

Displaying 195411-195420 of 1611142 results.
ID: 195411
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 808921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195412
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 195413
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1608333
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195414
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 261134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195415
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 108513
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195416
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1431977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195417
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 108514
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195418
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1431982
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195419
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1431987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195420
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0