CMS Formulary

Displaying 197081-197090 of 1611142 results.
ID: 197081
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197082
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197083
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197084
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197085
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197086
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197087
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197088
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197089
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197090
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0