CMS Formulary

Displaying 141601-141610 of 1611142 results.
ID: 141601
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141602
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141603
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141604
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141605
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141606
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141607
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141608
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141609
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141610
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0