CMS Formulary

Displaying 197851-197860 of 1611142 results.
ID: 197851
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197852
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197853
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197854
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197855
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197856
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197857
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197858
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197859
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197860
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0