CMS Formulary

Displaying 196571-196580 of 1611142 results.
ID: 196571
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196572
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196573
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196574
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196575
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1146690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196576
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 577776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196577
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196578
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196579
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196580
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1653217
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0