CMS Formulary

Displaying 188301-188310 of 1611142 results.
ID: 188301
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188302
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188303
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188304
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188305
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188306
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188307
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188308
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188309
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 188310
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0