CMS Formulary

Displaying 197711-197720 of 1611142 results.
ID: 197711
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 730834
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 197712
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197713
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197714
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197715
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197716
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197717
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197718
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197719
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197720
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0