CMS Formulary

Displaying 141961-141970 of 1611142 results.
ID: 141961
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141962
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141963
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141964
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141965
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1540246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141966
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1542994
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141967
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1541099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141968
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180345
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141969
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141970
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0