CMS Formulary

Displaying 141841-141850 of 1611142 results.
ID: 141841
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141842
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141843
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141844
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141845
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141846
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141847
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141848
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141849
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141850
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0