CMS Formulary

Displaying 224181-224190 of 1611142 results.
ID: 224181
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224182
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224183
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224184
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224185
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224186
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224187
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224188
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224189
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224190
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0