CMS Formulary

Displaying 199781-199790 of 1611142 results.
ID: 199781
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199782
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 199783
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199784
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199785
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199786
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199787
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 617995
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199788
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199789
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 199790
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0