CMS Formulary

Displaying 112581-112590 of 1611142 results.
ID: 112581
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112582
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112583
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112584
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112585
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112586
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112587
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112588
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112589
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112590
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0