CMS Formulary

Displaying 142211-142220 of 1611142 results.
ID: 142211
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142212
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403972
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142213
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403970
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142214
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142215
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142216
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142217
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142218
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 721787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142219
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142220
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0