CMS Formulary

Displaying 197871-197880 of 1611142 results.
ID: 197871
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197872
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197873
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197874
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197875
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197876
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197877
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197878
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 730869
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197879
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197880
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0