CMS Formulary

Displaying 204581-204590 of 1611142 results.
ID: 204581
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204582
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204583
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204584
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 244967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204585
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204586
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204587
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204588
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204589
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204590
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0