CMS Formulary

Displaying 189251-189260 of 1611142 results.
ID: 189251
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189252
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189253
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189254
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189255
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189256
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 835956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189257
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189258
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359032
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189259
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359027
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189260
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0