CMS Formulary

Displaying 213461-213470 of 1611142 results.
ID: 213461
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213462
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213463
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213464
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213465
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213466
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213467
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213468
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213469
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213470
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0