CMS Formulary

Displaying 195591-195600 of 1611142 results.
ID: 195591
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195592
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195593
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195594
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197446
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 195595
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195596
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195597
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195598
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195599
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195600
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0