CMS Formulary

Displaying 197741-197750 of 1611142 results.
ID: 197741
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197742
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197743
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197744
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197745
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197746
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197747
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197748
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197749
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197750
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0