CMS Formulary

Displaying 198211-198220 of 1611142 results.
ID: 198211
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198212
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198213
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198214
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897781
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198215
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198216
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 897844
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198217
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198218
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198219
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198220
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0