CMS Formulary

Displaying 209611-209620 of 1611142 results.
ID: 209611
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209612
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209613
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310473
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209614
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 242816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209615
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1870633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209616
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 310477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209617
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209618
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209619
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1863973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 209620
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0