CMS Formulary

Displaying 196781-196790 of 1611142 results.
ID: 196781
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312139
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196782
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 896110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196783
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 829539
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196784
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1191310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196785
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1246096
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196786
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196787
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 722111
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196788
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196789
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1376338
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196790
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0