CMS Formulary

Displaying 196421-196430 of 1611142 results.
ID: 196421
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196422
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196423
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196424
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 388517
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196425
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196426
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196427
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196428
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196429
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196430
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30