CMS Formulary

Displaying 216711-216720 of 1611142 results.
ID: 216711
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216712
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216713
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216714
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216715
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216716
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216717
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601982
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216718
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216719
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 244098
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216720
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 245220
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0