CMS Formulary

Displaying 198571-198580 of 1611142 results.
ID: 198571
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1999026
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198572
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1303131
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198573
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1303134
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198574
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1303137
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198575
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 994010
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 198576
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 994007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 198577
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198578
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198579
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2284516
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198580
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 2284514
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0