CMS Formulary

Displaying 114851-114860 of 1611142 results.
ID: 114851
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114852
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114853
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114854
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114855
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114856
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114857
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114858
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114859
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 204509
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114860
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0