CMS Formulary

Displaying 142151-142160 of 1611142 results.
ID: 142151
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142152
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142153
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142154
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142155
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300468
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142156
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607808
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142157
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 797641
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142158
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2360588
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142159
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142160
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0