CMS Formulary

Displaying 197761-197770 of 1611142 results.
ID: 197761
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 404475
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197762
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 404476
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197763
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197764
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197765
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2045245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197766
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197767
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197768
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197769
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197770
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 636141
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0