CMS Formulary

Displaying 195531-195540 of 1611142 results.
ID: 195531
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195532
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195533
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195534
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 728122
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195535
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195536
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195537
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195538
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195539
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195540
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0