CMS Formulary

Displaying 208151-208160 of 1611142 results.
ID: 208151
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208152
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208153
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208154
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208155
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208156
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208157
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208158
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208159
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208160
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0