CMS Formulary

Displaying 195731-195740 of 1611142 results.
ID: 195731
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 360507
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195732
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195733
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195734
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195735
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 892494
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195736
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 892596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195737
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 892345
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195738
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 894801
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195739
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 892352
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195740
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 894814
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0