CMS Formulary

Displaying 195981-195990 of 1611142 results.
ID: 195981
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195982
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195983
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195984
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 485023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195985
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195986
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195987
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 485020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195988
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 195989
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 195990
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30