CMS Formulary

Displaying 197111-197120 of 1611142 results.
ID: 197111
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197112
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197113
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197114
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 197115
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 197116
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 197117
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 197118
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1100075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197119
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197120
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0