CMS Formulary

Displaying 208461-208470 of 1611142 results.
ID: 208461
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 351156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208462
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208463
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208464
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208465
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208466
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208467
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208468
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208469
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 540617
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 208470
Formulary ID: 00021087
Formulary Version: 13
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0