CMS Formulary

Displaying 197751-197760 of 1611142 results.
ID: 197751
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 197752
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 197753
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 197754
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 197755
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 197756
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197757
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197758
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2000136
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197759
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197760
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 800918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0