CMS Formulary

Displaying 219581-219590 of 1611142 results.
ID: 219581
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219582
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219583
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219584
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219585
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219586
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219587
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219588
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219589
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219590
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0