CMS Formulary

Displaying 197071-197080 of 1611142 results.
ID: 197071
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197072
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197073
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197074
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197075
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197076
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197077
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197078
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197079
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197080
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0