CMS Formulary

Displaying 142481-142490 of 1611142 results.
ID: 142481
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142482
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142483
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142484
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741905
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142485
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142486
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142487
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142488
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142489
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 700408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142490
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0