CMS Formulary

Displaying 222861-222870 of 1611142 results.
ID: 222861
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 486515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222862
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 730782
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222863
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795470
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222864
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1794886
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222865
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795346
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222866
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222867
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 800588
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222868
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 310473
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222869
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 242816
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 222870
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1870633
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0