CMS Formulary

Displaying 198611-198620 of 1611142 results.
ID: 198611
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198612
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198613
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198614
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198615
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 967021
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198616
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1248442
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198617
Formulary ID: 00021083
Formulary Version: 17
Contract Year: 2021
RXCUI: 1482689
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198618
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198619
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198620
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28