CMS Formulary

Displaying 198291-198300 of 1611142 results.
ID: 198291
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 198363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198292
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 200220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198293
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198294
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198295
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198296
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198297
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 198298
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2393794
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198299
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2121764
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198300
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2173841
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0