CMS Formulary

Displaying 141901-141910 of 1611142 results.
ID: 141901
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141902
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 794979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141903
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141904
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141905
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141906
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905341
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141907
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141908
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141909
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141910
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0