CMS Formulary

Displaying 231381-231390 of 1611142 results.
ID: 231381
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231382
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1246673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231383
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231384
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231385
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231386
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231387
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231388
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231389
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231390
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0