CMS Formulary

Displaying 142041-142050 of 1611142 results.
ID: 142041
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142042
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142043
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142044
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142045
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142046
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142047
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1608276
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142048
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1608274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142049
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142050
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0