CMS Formulary

Displaying 206651-206660 of 1611142 results.
ID: 206651
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206652
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206653
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206654
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206655
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206656
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206657
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206658
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206659
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 206660
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0