CMS Formulary

Displaying 209561-209570 of 1611142 results.
ID: 209561
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209562
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209563
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209564
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209565
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601982
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209566
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209567
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 244098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209568
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 245220
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209569
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209570
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0