CMS Formulary

Displaying 196521-196530 of 1611142 results.
ID: 196521
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196522
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 196523
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 196524
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196525
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196526
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196527
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196528
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196529
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196530
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0