CMS Formulary

Displaying 196331-196340 of 1611142 results.
ID: 196331
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 597987
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196332
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 597977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196333
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 597971
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196334
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196335
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196336
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196337
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196338
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196339
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196340
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0