CMS Formulary

Displaying 213171-213180 of 1611142 results.
ID: 213171
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 310477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213172
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213173
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213174
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1863973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213175
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213176
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1863605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213177
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 615099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213178
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 615100
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213179
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213180
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 637551
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0