CMS Formulary

Displaying 196681-196690 of 1611142 results.
ID: 196681
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196682
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196683
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196684
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196685
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 196686
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 196687
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196688
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196689
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 51
Qty Limit Days: 30
ID: 196690
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0