CMS Formulary

Displaying 216221-216230 of 1611142 results.
ID: 216221
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216222
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216223
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216224
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216225
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216226
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216227
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216228
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216229
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216230
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0