CMS Formulary

Displaying 197421-197430 of 1611142 results.
ID: 197421
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197422
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197423
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197424
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197425
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197426
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197427
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197428
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197429
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197430
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0