CMS Formulary

Displaying 142471-142480 of 1611142 results.
ID: 142471
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142472
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142473
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142474
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142475
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142476
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142477
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142478
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142479
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 967017
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142480
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0