CMS Formulary

Displaying 196411-196420 of 1611142 results.
ID: 196411
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196412
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 196413
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196414
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196415
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 895990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196416
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196417
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196418
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1191307
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196419
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196420
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0