CMS Formulary

Displaying 198091-198100 of 1611142 results.
ID: 198091
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198092
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 826612
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198093
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198094
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198095
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198096
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198097
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198098
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 854894
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198099
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 854880
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198100
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30