CMS Formulary

Displaying 203381-203390 of 1611142 results.
ID: 203381
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203382
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203383
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203384
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203385
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203386
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203387
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203388
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 730866
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203389
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203390
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0