CMS Formulary

Displaying 198311-198320 of 1611142 results.
ID: 198311
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 753437
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198312
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 753439
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198313
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 753442
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198314
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 753443
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198315
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 877417
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198316
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198317
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198318
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664463
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198319
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664440
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198320
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0