CMS Formulary

Displaying 142251-142260 of 1611142 results.
ID: 142251
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994764
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142252
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142253
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106997
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142254
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1660690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142255
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2397128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142256
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314106
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142257
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311681
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142258
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142259
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142260
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0