CMS Formulary

Displaying 203531-203540 of 1611142 results.
ID: 203531
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203532
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203533
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203534
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203535
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203536
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203537
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203538
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203539
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203540
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0