CMS Formulary

Displaying 203361-203370 of 1611142 results.
ID: 203361
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203362
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203363
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203364
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203365
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203366
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203367
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203368
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 203369
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203370
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0