CMS Formulary

Displaying 204191-204200 of 1611142 results.
ID: 204191
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204192
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204193
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204194
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204195
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204196
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204197
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204198
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204199
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204200
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0