CMS Formulary

Displaying 196841-196850 of 1611142 results.
ID: 196841
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1359027
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196842
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1293456
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196843
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196844
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196845
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196846
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196847
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1020039
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196848
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196849
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196850
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 749148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0