CMS Formulary

Displaying 197891-197900 of 1611142 results.
ID: 197891
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 582595
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197892
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861966
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197893
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 197894
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 140
Qty Limit Days: 28
ID: 197895
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197896
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197897
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197898
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197899
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197900
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30