CMS Formulary

Displaying 187761-187770 of 1611142 results.
ID: 187761
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187762
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187763
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187764
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187765
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601982
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187766
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187767
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 244098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187768
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 245220
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187769
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187770
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0