CMS Formulary

Displaying 200241-200250 of 1611142 results.
ID: 200241
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200242
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200243
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200244
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200245
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200246
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200247
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200248
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200249
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200250
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0