CMS Formulary

Displaying 215601-215610 of 1611142 results.
ID: 215601
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215602
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215603
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215604
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215605
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 540617
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215606
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215607
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 213337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215608
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215609
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215610
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0