CMS Formulary

Displaying 212391-212400 of 1611142 results.
ID: 212391
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1247381
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212392
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212393
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212394
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212395
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212396
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 198049
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212397
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212398
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1190110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212399
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 212400
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0