CMS Formulary

Displaying 196511-196520 of 1611142 results.
ID: 196511
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2102784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196512
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196513
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196514
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196515
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196516
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 196517
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 196518
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196519
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196520
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0