CMS Formulary

Displaying 195691-195700 of 1611142 results.
ID: 195691
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 195692
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195693
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 195694
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195695
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195696
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195697
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195698
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195699
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195700
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0