CMS Formulary

Displaying 196581-196590 of 1611142 results.
ID: 196581
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 851750
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196582
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196583
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1111018
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196584
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 798061
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196585
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 212381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196586
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196587
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196588
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196589
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196590
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0