CMS Formulary

Displaying 142761-142770 of 1611142 results.
ID: 142761
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860522
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142762
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860532
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142763
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142764
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142765
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142766
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142767
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142768
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142769
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142770
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0