CMS Formulary

Displaying 211291-211300 of 1611142 results.
ID: 211291
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 205922
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211292
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 205924
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211293
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211294
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 212219
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211295
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 213475
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211296
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211297
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211298
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211299
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 211300
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0