CMS Formulary

Displaying 209381-209390 of 1611142 results.
ID: 209381
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209382
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299896
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209383
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209384
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209385
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209386
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209387
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209388
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209389
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209390
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0