CMS Formulary

Displaying 197931-197940 of 1611142 results.
ID: 197931
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 896184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197932
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 896209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197933
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 896228
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197934
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197935
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197936
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197937
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197938
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 197939
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197940
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0