CMS Formulary

Displaying 198491-198500 of 1611142 results.
ID: 198491
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 198492
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 198493
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 198494
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 198495
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 198496
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2059280
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 14
ID: 198497
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198498
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1249631
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198499
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 198500
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30