CMS Formulary

Displaying 197981-197990 of 1611142 results.
ID: 197981
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 197982
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197983
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197984
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197985
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197986
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 197987
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1013665
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197988
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1013659
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197989
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 197990
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0