CMS Formulary

Displaying 195791-195800 of 1611142 results.
ID: 195791
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195792
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195793
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195794
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195795
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195796
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195797
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195798
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 207249
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195799
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1543182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195800
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0