CMS Formulary

Displaying 196611-196620 of 1611142 results.
ID: 196611
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196612
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 692757
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196613
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196614
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196615
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 477367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196616
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 477372
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196617
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2391560
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196618
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196619
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196620
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0