CMS Formulary

Displaying 226631-226640 of 1611142 results.
ID: 226631
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226632
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226633
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226634
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226635
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226636
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226637
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226638
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226639
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 226640
Formulary ID: 00021098
Formulary Version: 10
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0