CMS Formulary

Displaying 203651-203660 of 1611142 results.
ID: 203651
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203652
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 861467
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203653
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 861455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203654
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203655
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203656
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203657
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203658
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203659
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203660
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0