CMS Formulary

Displaying 216741-216750 of 1611142 results.
ID: 216741
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 242816
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216742
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1870633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216743
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 310477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216744
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216745
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216746
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216747
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1863973
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216748
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216749
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 1863605
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 216750
Formulary ID: 00021095
Formulary Version: 13
Contract Year: 2021
RXCUI: 615099
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0