CMS Formulary

Displaying 113661-113670 of 1611142 results.
ID: 113661
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113662
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113663
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113664
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113665
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113666
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113667
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113668
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113669
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113670
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0