CMS Formulary

Displaying 142461-142470 of 1611142 results.
ID: 142461
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142462
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142463
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142464
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142465
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142466
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142467
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142468
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142469
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142470
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0