CMS Formulary

Displaying 213161-213170 of 1611142 results.
ID: 213161
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 486515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213162
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 730782
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213163
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213164
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1794886
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213165
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213166
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213167
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213168
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310473
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213169
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 242816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213170
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1870633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0