CMS Formulary

Displaying 213471-213480 of 1611142 results.
ID: 213471
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213472
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213473
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213474
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213475
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213476
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213477
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213478
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 404062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213479
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 643488
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 213480
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0