CMS Formulary

Displaying 196711-196720 of 1611142 results.
ID: 196711
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196712
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 196713
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196714
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196715
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196716
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 994226
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196717
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861353
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196718
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 899660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196719
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 899521
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196720
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 899690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0