CMS Formulary

Displaying 195571-195580 of 1611142 results.
ID: 195571
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195572
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 195573
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 195574
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195575
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 828299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195576
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 195577
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195578
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 994237
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195579
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 857564
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195580
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0