CMS Formulary

Displaying 220261-220270 of 1611142 results.
ID: 220261
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220262
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220263
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220264
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220265
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220266
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220267
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220268
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220269
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 220270
Formulary ID: 00021096
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0