CMS Formulary

Displaying 196791-196800 of 1611142 results.
ID: 196791
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196792
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196793
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196794
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196795
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196796
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196797
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196798
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196799
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196800
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0