CMS Formulary

Displaying 197641-197650 of 1611142 results.
ID: 197641
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197642
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1722919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197643
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1722921
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197644
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1117522
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197645
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664981
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197646
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197647
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197648
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197649
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 730781
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197650
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0