CMS Formulary

Displaying 205491-205500 of 1611142 results.
ID: 205491
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205492
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205493
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205494
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205495
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205496
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205497
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205498
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205499
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 205500
Formulary ID: 00021086
Formulary Version: 18
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0