CMS Formulary

Displaying 204691-204700 of 1611142 results.
ID: 204691
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 476351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204692
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204693
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204694
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204695
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204696
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204697
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204698
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204699
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204700
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0