CMS Formulary

Displaying 113991-114000 of 1611142 results.
ID: 113991
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113992
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113993
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113994
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113995
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113996
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113997
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994764
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113998
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113999
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106997
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114000
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1660690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0