CMS Formulary

Displaying 196661-196670 of 1611142 results.
ID: 196661
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 196662
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196663
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 978950
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196664
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1483551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196665
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1483554
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196666
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 196667
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 402252
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 196668
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 196669
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196670
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373469
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0