CMS Formulary

Displaying 203881-203890 of 1611142 results.
ID: 203881
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 403972
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203882
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 403970
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203883
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 403971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203884
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203885
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203886
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1251903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203887
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 721787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203888
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203889
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 203890
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0