CMS Formulary

Displaying 113391-113400 of 1611142 results.
ID: 113391
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113392
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113393
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113394
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113395
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113396
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113397
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113398
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113399
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113400
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0