CMS Formulary

Displaying 197041-197050 of 1611142 results.
ID: 197041
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197042
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197043
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205923
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197044
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197045
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205912
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197046
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197047
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 212218
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197048
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197049
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197050
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30