CMS Formulary

Displaying 214361-214370 of 1611142 results.
ID: 214361
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214362
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 403969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214363
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 403972
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214364
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 403970
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214365
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 403971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214366
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214367
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214368
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214369
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 721787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214370
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0