CMS Formulary

Displaying 198461-198470 of 1611142 results.
ID: 198461
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198462
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198463
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1011712
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198464
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1011715
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198465
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1011752
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198466
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1011755
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 198467
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 198468
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1927672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 198469
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1946651
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198470
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0