CMS Formulary

Displaying 197181-197190 of 1611142 results.
ID: 197181
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 197182
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197183
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197184
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 197185
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 197186
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 197187
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 104206
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197188
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197189
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309889
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197190
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1998774
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30