CMS Formulary

Displaying 197591-197600 of 1611142 results.
ID: 197591
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1092360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2400
Qty Limit Days: 30
ID: 197592
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197593
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197594
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197595
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2054159
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197596
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197597
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197598
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197599
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197600
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0