CMS Formulary

Displaying 195861-195870 of 1611142 results.
ID: 195861
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195862
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195863
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195864
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195865
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195866
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195867
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195868
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195869
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195870
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0