CMS Formulary

Displaying 189391-189400 of 1611142 results.
ID: 189391
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 824959
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189392
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189393
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189394
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189395
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189396
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189397
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189398
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189399
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1743547
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189400
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0