CMS Formulary

Displaying 198731-198740 of 1611142 results.
ID: 198731
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198732
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198733
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 260285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198734
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 205826
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198735
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1011987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198736
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 856935
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198737
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 198738
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 486155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 198739
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 310173
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 198740
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1149645
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28