CMS Formulary

Displaying 197621-197630 of 1611142 results.
ID: 197621
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 790264
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197622
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197623
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197624
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197625
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197626
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197627
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1658221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197628
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197629
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 197630
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0