CMS Formulary

Displaying 230391-230400 of 1611142 results.
ID: 230391
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230392
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230393
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230394
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230395
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230396
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230397
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230398
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230399
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 899461
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230400
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 899485
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0