CMS Formulary

Displaying 197691-197700 of 1611142 results.
ID: 197691
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 902626
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197692
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197693
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197694
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197695
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197696
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 197697
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 197698
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1737789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197699
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197700
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0