CMS Formulary

Displaying 200151-200160 of 1611142 results.
ID: 200151
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200152
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200153
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200154
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200155
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200156
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200157
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200158
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200159
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200160
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0