CMS Formulary

Displaying 195621-195630 of 1611142 results.
ID: 195621
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195622
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1602115
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195623
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 195624
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195625
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195626
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195627
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195628
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195629
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195630
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2359285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0