CMS Formulary

Displaying 219691-219700 of 1611142 results.
ID: 219691
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219692
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219693
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219694
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219695
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219696
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219697
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219698
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219699
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 219700
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0