CMS Formulary

Displaying 202461-202470 of 1611142 results.
ID: 202461
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202462
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202463
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202464
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202465
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202466
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202467
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 202468
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202469
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 202470
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0