CMS Formulary

Displaying 196851-196860 of 1611142 results.
ID: 196851
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196852
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196853
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1995136
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196854
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196855
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196856
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2106585
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196857
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2047646
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196858
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 196859
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 196860
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 668363
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0