CMS Formulary

Displaying 204931-204940 of 1611142 results.
ID: 204931
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204932
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204933
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204934
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204935
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 204936
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 204937
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204938
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204939
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 204940
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0