CMS Formulary

Displaying 142551-142560 of 1611142 results.
ID: 142551
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 844591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142552
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 844829
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142553
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142554
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142555
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142556
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116351
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142557
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1792386
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142558
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1426600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142559
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142560
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0