CMS Formulary

Displaying 215721-215730 of 1611142 results.
ID: 215721
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215722
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215723
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215724
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215725
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215726
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1874537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215727
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215728
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215729
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 215730
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0