CMS Formulary

Displaying 209331-209340 of 1611142 results.
ID: 209331
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 309043
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209332
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209333
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209334
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209335
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209336
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209337
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209338
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209339
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209340
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0