CMS Formulary

Displaying 189421-189430 of 1611142 results.
ID: 189421
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 352046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189422
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 352047
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189423
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1654955
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189424
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 731227
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189425
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 731250
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189426
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 730046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189427
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 731231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189428
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 731235
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189429
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 731241
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 189430
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 731245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0