CMS Formulary

Displaying 195961-195970 of 1611142 results.
ID: 195961
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195962
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195963
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195964
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195965
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 195966
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195967
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195968
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195969
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195970
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0