CMS Formulary

Displaying 196281-196290 of 1611142 results.
ID: 196281
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 994521
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196282
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091389
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196283
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091322
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196284
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091152
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196285
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 860771
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196286
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196287
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1232202
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196288
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1232194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196289
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196290
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0