CMS Formulary

Displaying 114161-114170 of 1611142 results.
ID: 114161
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114162
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114163
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114164
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114165
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114166
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114167
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114168
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114169
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114170
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30