CMS Formulary

Displaying 141471-141480 of 1611142 results.
ID: 141471
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1233711
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141472
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013867
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141473
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141474
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141475
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141476
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141477
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141478
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141479
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141480
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 406503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0