CMS Formulary

Displaying 199121-199130 of 1611142 results.
ID: 199121
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 199122
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 199123
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 199124
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199125
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199126
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199127
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199128
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199129
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199130
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 1