CMS Formulary

Displaying 202171-202180 of 1611142 results.
ID: 202171
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 153579
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202172
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 153580
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202173
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 897294
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202174
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202175
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202176
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202177
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202178
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202179
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202180
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0