CMS Formulary

Displaying 197681-197690 of 1611142 results.
ID: 197681
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197682
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197683
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197684
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373493
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197685
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373498
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197686
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 197687
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 197688
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197689
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197690
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 902624
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0