CMS Formulary

Displaying 195871-195880 of 1611142 results.
ID: 195871
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195872
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195873
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195874
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195875
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195876
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195877
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195878
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195879
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195880
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30