CMS Formulary

Displaying 119071-119080 of 1611142 results.
ID: 119071
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119072
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119073
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119074
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119075
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198032
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119076
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119077
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119078
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197854
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119079
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119080
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0