CMS Formulary

Displaying 207771-207780 of 1611142 results.
ID: 207771
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207772
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207773
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207774
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207775
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207776
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207777
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207778
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207779
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 207780
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0