CMS Formulary

Displaying 201171-201180 of 1611142 results.
ID: 201171
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201172
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201173
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201174
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201175
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201176
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201177
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2001564
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 201178
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1738803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201179
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1738805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201180
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1738807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0