CMS Formulary

Displaying 200431-200440 of 1611142 results.
ID: 200431
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200432
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200433
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200434
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200435
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200436
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200437
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200438
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200439
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 200440
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0