CMS Formulary

Displaying 203291-203300 of 1611142 results.
ID: 203291
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203292
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203293
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203294
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203295
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203296
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203297
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203298
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1233711
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203299
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203300
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0