CMS Formulary

Displaying 115461-115470 of 1611142 results.
ID: 115461
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115462
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115463
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198032
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115464
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115465
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115466
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197854
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115467
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115468
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115469
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115470
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0