CMS Formulary

Displaying 200161-200170 of 1611142 results.
ID: 200161
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200162
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200163
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200164
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200165
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200166
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200167
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200168
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 200169
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 200170
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0