CMS Formulary

Displaying 200941-200950 of 1611142 results.
ID: 200941
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200942
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200943
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200944
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200945
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200946
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200947
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200948
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200949
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200950
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0