CMS Formulary

Displaying 142101-142110 of 1611142 results.
ID: 142101
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142102
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142103
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142104
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142105
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142106
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142107
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142108
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142109
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142110
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0