CMS Formulary

Displaying 195561-195570 of 1611142 results.
ID: 195561
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195562
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195563
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1431286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195564
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195565
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195566
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195567
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195568
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 745791
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195569
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195570
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0