CMS Formulary

Displaying 142261-142270 of 1611142 results.
ID: 142261
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142262
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142263
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142264
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142265
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142266
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142267
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142268
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 833463
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142269
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142270
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0