CMS Formulary

Displaying 231481-231490 of 1611142 results.
ID: 231481
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231482
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231483
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231484
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 199370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231485
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231486
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231487
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231488
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231489
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 231490
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0