CMS Formulary

Displaying 196691-196700 of 1611142 results.
ID: 196691
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196692
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196693
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196694
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1811011
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196695
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1811007
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196696
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1811003
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196697
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1810999
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196698
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 196699
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 196700
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0