CMS Formulary

Displaying 231181-231190 of 1611142 results.
ID: 231181
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 311681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231182
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 856377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231183
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231184
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231185
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231186
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231187
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231188
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231189
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231190
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0