CMS Formulary

Displaying 114291-114300 of 1611142 results.
ID: 114291
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114292
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114293
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114294
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114295
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114296
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114297
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114298
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114299
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114300
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0