CMS Formulary

Displaying 213371-213380 of 1611142 results.
ID: 213371
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213372
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213373
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213374
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213375
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213376
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213377
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213378
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213379
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213380
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0