CMS Formulary

Displaying 196761-196770 of 1611142 results.
ID: 196761
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196762
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196763
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196764
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196765
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196766
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196767
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196768
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196769
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196770
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 966577
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0