CMS Formulary

Displaying 196531-196540 of 1611142 results.
ID: 196531
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196532
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196533
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196534
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196535
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196536
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196537
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196538
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196539
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196540
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30