CMS Formulary

Displaying 142621-142630 of 1611142 results.
ID: 142621
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142622
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142623
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433736
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142624
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142625
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142626
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142627
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142628
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142629
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142630
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0