CMS Formulary

Displaying 113851-113860 of 1611142 results.
ID: 113851
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113852
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113853
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113854
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 113855
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113856
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113857
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113858
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113859
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113860
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0