CMS Formulary

Displaying 142231-142240 of 1611142 results.
ID: 142231
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142232
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142233
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142234
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142235
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142236
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142237
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142238
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1146690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142239
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 577776
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142240
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0