CMS Formulary

Displaying 196971-196980 of 1611142 results.
ID: 196971
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196972
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 196973
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196974
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312132
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196975
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196976
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196977
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196978
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196979
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 196980
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0