CMS Formulary

Displaying 113981-113990 of 1611142 results.
ID: 113981
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113982
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113983
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113984
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113985
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1146690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113986
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 577776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113987
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113988
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113989
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113990
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 851750
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0