CMS Formulary

Displaying 197091-197100 of 1611142 results.
ID: 197091
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197092
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197093
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 860510
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197094
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 860516
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197095
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 860522
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197096
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 860532
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197097
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197098
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197099
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197100
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0