CMS Formulary

Displaying 231161-231170 of 1611142 results.
ID: 231161
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231162
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231163
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231164
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231165
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231166
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231167
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231168
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231169
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231170
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1146690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0