CMS Formulary

Displaying 142001-142010 of 1611142 results.
ID: 142001
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142002
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597977
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142003
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142004
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142005
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142006
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142007
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142008
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142009
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142010
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0