CMS Formulary

Displaying 229581-229590 of 1611142 results.
ID: 229581
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229582
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 309043
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229583
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229584
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229585
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229586
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229587
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229588
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229589
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 229590
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0