CMS Formulary

Displaying 195661-195670 of 1611142 results.
ID: 195661
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1293639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 195662
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1191256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195663
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195664
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195665
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195666
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195667
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195668
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195669
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195670
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0