CMS Formulary

Displaying 115781-115790 of 1611142 results.
ID: 115781
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003757
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115782
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003767
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115783
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115784
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115785
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115786
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115787
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115788
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115789
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115790
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0