CMS Formulary

Displaying 197331-197340 of 1611142 results.
ID: 197331
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197332
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197333
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197334
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197335
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197336
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197337
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197338
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197339
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308739
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 25
ID: 197340
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0