CMS Formulary

Displaying 197371-197380 of 1611142 results.
ID: 197371
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197372
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197373
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197374
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1603501
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197375
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197376
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197377
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197378
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197379
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197380
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0