CMS Formulary

Displaying 195681-195690 of 1611142 results.
ID: 195681
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 899461
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195682
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 899485
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195683
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1101926
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195684
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 899495
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195685
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1101932
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195686
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195687
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195688
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195689
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 195690
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1657173
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30