CMS Formulary

Displaying 203441-203450 of 1611142 results.
ID: 203441
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203442
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203443
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203444
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203445
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203446
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203447
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 203448
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203449
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203450
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0