CMS Formulary

Displaying 195891-195900 of 1611142 results.
ID: 195891
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195892
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195893
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195894
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195895
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195896
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195897
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195898
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195899
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195900
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 902741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0