CMS Formulary

Displaying 203671-203680 of 1611142 results.
ID: 203671
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203672
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203673
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203674
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203675
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203676
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203677
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203678
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203679
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203680
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0