CMS Formulary

Displaying 224791-224800 of 1611142 results.
ID: 224791
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224792
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224793
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 313416
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224794
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224795
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224796
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224797
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224798
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224799
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 224800
Formulary ID: 00021097
Formulary Version: 13
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0