CMS Formulary

Displaying 197351-197360 of 1611142 results.
ID: 197351
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197352
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197353
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197354
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 485486
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197355
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 485485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197356
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 485484
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197357
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197358
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197359
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 197360
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28