CMS Formulary

Displaying 196211-196220 of 1611142 results.
ID: 196211
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196212
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196213
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196214
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196215
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196216
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196217
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196218
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196219
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 196220
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0